Achi news desk-
The Alberta government says it will pay nurse practitioners 80 per cent of what GPs pay – if they want to practice comprehensive primary care.
A payment model for the new Nurse Practitioner Primary Care Program has been finalized.
The programme, announced in November, will allow nurse practitioners (NPs) to operate their own publicly funded practices, whether in independent clinics or in existing primary care clinics.
“It will certainly expand access for individuals who want to find a primary care provider, given the fact that we will now have nurse practitioners who can have their own panel of patients,” Health Minister Adriana LaGrange said Wednesday.
LaGrange said NPs will have to apply and be accepted into the program.
To qualify, a practitioner must commit to caring for at least 900 patients and offer services after hours on weekends, evenings and holidays.
Those accepted will receive 80 per cent of the funding received from GPs.
“Nurse practitioners can do about 80 percent of the services that doctors can do,” LaGrange explained. “They don’t do surgery, they usually also don’t provide services within hospitals like doctors do.”
Panel size
Jennifer Wankiewicz, owner and president of the River Stone Nurse Practitioner Clinic, said NPs are an underutilized health care workforce in Canada.
He said they offer many of the services a GP does, such as referrals, diagnostics and prescriptions – although some drugs are restricted.
While she is excited about the new program, Wankiewicz said she is unsure how realistic the minimum 900 patient panel will be.
“Given that nurse practitioners spend a great deal more time with their patients than a family doctor often does… that’s a tough number for them,” Wankiewicz said. “It remains to be seen whether that number will stop and give them the opportunity to provide the care they want.”
Depending on how services are delivered, Wankiewicz said her clinic could employ eight full-time NPs and care for between 6,000 and 9,000 clients.
Currently, NP clinics like River Stone charge for services or offer paid membership fees.
LaGrange said any NPs in the new program will no longer be able to charge for services covered by the province under the Canada Health Act.
Funding model
Jennifer Mador, president of the Nurse Practitioners Association of Alberta (NPAA) said the program is a “great development” for the profession.
However, its ultimate success will depend on the long-term viability of the funding model, he said, pointing to the financial difficulties Alberta’s family doctors have faced in recent years.
“We are not naive to the fact that our physician colleagues have been struggling with their funding model,” he said. “That is not lost on us.
“So we need to ensure over the long term that the funding model is sustainable and keeps these PC clinics viable.”
Mador said she hopes to see a higher level of compensation offered, and will look to renegotiate in the future.
“Of course, we would like to see equal pay for equal work,” he said. “Nurse practitioners will not get a 20 per cent reduction on their overheads or any other costs they need to be able to run these clinics.”
The province said overhead and costs associated with practice were included in the compensation rate.
According to Lorian Hardcastle, a law professor at the University of Calgary, the 80 per cent funding model could see some pushback from Alberta doctors, souring an already strained relationship.
In addition to spending more on training and having higher student loan debt, Hardcastle said many family doctors have been struggling financially for years amid ongoing negotiations with the province.
“This nurse practitioner model compensates them based on the size of their patient panel and those kinds of factors,” she added. “And doctors have had to fight long and hard to get to a point where they have the same compensation models available to them, rather than a fee for service type model.”
CTV News Edmonton has reached out to the Alberta Medical Association and is awaiting a response.
The province said audits of the program will take place after 18 and 48 months.
LaGrange said there are currently about 600,000 Albertans without a family doctor.
With files from Chelan Skulski CTV News Edmonton
