Clinical ARP Rates

Clinical ARP Rate Methodology

Alberta Health's clinical ARP rates are referred to as Provincial Base Payment Rates (PBPR). AH has taken the position that these are non-negotiable as they are currently used to remunerate physicians in existing clinical ARPs.

Most PBPR rates were originally derived from 2002/2003 fee-for-service (FFS) billing data in a specific specialty using modified (Canadian Institute of Health Information (CIHI) methodology. Rates were subsequently updated over time using the same sectional increases negotiated for the FFS schedule through periodic re-negotiations and sectional allocations. The methodology used the average number of service event days (billed in the 40th-60th percentile).

In recent years, AH has shifted from program service days to a model that defines annual service hours. Recently, AH has returned to using program service days for some specialties being offered cARPs. The AMA’s opinion is annual rates and the associated clinical service commitment (either annual hours or program service days) should be negotiated with the AMA.

The AH-AMA Clinical ARP Working Group is currently working towards consensus on new rate methodology and clinical ARP rates. 

Clinical ARP Rates

Annualized Model

In the annualized model, the maximum approved funding for the clinical ARP (cARP) is equal to the Provincial Base Payment Rate (PBPR) multiplied by the number of approved full-time equivalents (FTEs). The number of approved FTEs for the cARP is calculated based on a reasonable amount of program services that can be delivered by each 1.0 FTE. An FTE is a time-based unit of measure (e.g., days per year or hours per year), which is typically derived from the average days worked (ADW) per year for 1.0 FTE in each specialty. The ADW was determined through the modified CIHI methodology calculations as any day with one or more billing events.

For general practitioners (GPs), one common FTE definition is 241 Program Service Days (PSDs), where a PSD equals program services provided within 24-hour period from 12:00 a.m. to 11:59 p.m. Another common GP FTE definition (used by Alberta Health for all new GP cARPs) is 1,928 annual hours of program service per 1.0 FTE. Although this is managed as an annual figure, it was derived from taking the GP ADW of 241 days multiplied by eight hours per day.

Sessional Model

In a sessional model, compensation is based on an hourly rate for the delivery of clinical services. This model applies to small, specialized programs and is intended for part-time participation up to an average of two days (16 hours) per week. The current clinical ARP sessional rate for GPs and specialists is $228.45 per hour.

Capitation Model

There are two legacy full capitation clinical ARP programs in operation (Crowfoot Village Family Practice and the Taber Clinic). The capitation rates for these primary care programs are based on age and gender for each rostered patient. These models are not currently available to new applicants.

Provincial Base Payment Rate (PBPR)

The following rates are currently used for clinical ARPs:

Blended Capitation Model

The blended capitation model is intended for primary care practices. More information on this model can be found on the AMA's BCM webpage.