Alberta government halts changes to doctors’ pay for complex modifiers

The Alberta government announced Tuesday that changes to physicians’ payments for complex modifiers will not go ahead as planned on March 31.

The changes would have impacted how doctors are compensated for time spent on patient visits and potentially the number of issues a patient could see their doctor about.

Under the previously proposed changes, these fees would mandate more time be spent with patients with complex needs, 25 minutes instead of 15, before an extra fee would kick in. This plan was to be phased in next year.

For this year, the complex modifier was still charged at the 15-minute benchmark, but would pay $9 instead of $18. The Alberta Medical Association, or AMA, says these changes could limit services, lead to physicians focusing on non-complex patients and bankrupt some rural and family offices.

The news came on the same day Alberta announced a public health emergency in light of COVID-19.

“During these unprecedented times, we want to ensure physicians on the front lines can focus solely on providing patient care,” Health Minister Tyler Shandro said.

“We’ve heard concerns that this change would result in what has been called ’10-minute medicine.’ While we respectfully disagree with that characterization, we are nevertheless halting this change so that doctors can concentrate on the critical tasks at hand.”

“We appreciate the removal of the complex (time) modifier from Alberta Health’s physician funding framework,” Dr. Christine Molnar, president of the Alberta Medical Association, said.

“This is a significant step in supporting patients and physicians. There is still work to be done. We will work in any venue to advance patient care and to reach a formal agreement between physicians and Alberta Health.”

In a letter to members, Molnar called the move “great news.”

She said it came out of discussions last week between the working group of the Alberta Medical Association and government.

Molnar said the AMA wants the government to delay the implementation of the rest of the Physician Funding Framework and to implement “codes or other necessary payments to allow for patient care in a safe, appropriate and timely fashion during the COVID-19 pandemic.”

She stressed the province has been “so visibly involved with numerous actions to support Albertans” during this health crisis.

“There is clear government leadership, with expert public health communications, promotion of social distancing and providing direction to the public.

“Also, I think our friends in laboratory medicine deserve particular recognition for their high quality work under extreme pressure.”

Hundreds of physicians are urging the Alberta government to not only put upcoming contract changes on hold but also take further steps to help prevent the novel coronavirus pandemic from overwhelming the province’s health-care system.

READ MORE: Alberta government ends master agreement with doctors; new rules coming April 1

A letter written by Dr. Lana Myroniuk, a family doctor in Edmonton, on behalf of 558 other Alberta physicians was sent to Premier Jason Kenney, Prime Minister Justin Trudeau, provincial Health Minister Tyler Shandro and other members of the Alberta legislature on Sunday night.

Myroniuk said enacting the phone call billing code and pledging not to lay off nurses was a good start, but more needs to be done. The doctors called on the province to do the following four things:

1. Reverse the cuts to physician fees and table negotiations for a later date, when the province is not in crisis
2. Remove the weekly cap for 03.05JR (telephone calls to patients). This will promote social distancing and enable telephone care even if the patient and/or physician are not required to self-isolate
3. Increase the fee for 03.01AD to align with other provinces
4. Reassure Albertans that everyone who must self-isolate, physicians included, will receive financial support from the government. Otherwise, infected individuals will continue to go to work and further spread the virus

The province said a physician compensation advisory committee will be created to examine all aspects of the physician services funding model and make recommendations supporting the delivery of health services to Albertans.