Province introducing “Patient-Focused Funding Model” to fund acute care in Alberta

Alberta’s government is introducing a new acute care funding model, increasing the accountability, efficiency and volume of high-quality surgical delivery.

Currently, the health care system is primarily funded by a single grant made to Alberta Health Services to deliver health care across the province. This grant has grown by $3.4 billion since 2018-19, and although Alberta performed about 20,000 more surgeries this past year than at that time, this is not good enough. Albertans deserve surgical wait times that don’t just marginally improve but meet the medically recommended wait times for every single patient.

With Acute Care Alberta now fully operational, Alberta’s government is implementing reforms to acute care funding through a patient-focused funding (PFF) model, also known as activity-based funding, which pays hospitals based on the services they provide.

“The current global budgeting model has no incentives to increase volume, no accountability and no cost predictability for taxpayers. By switching to an activity-based funding model, our health care system will have built-in incentives to increase volume with high quality, cost predictability for taxpayers and accountability for all providers. This approach will increase transparency, lower wait times and attract more surgeons – helping deliver better health care for all Albertans, when and where they need it.”

Danielle Smith, Premier

Activity-based funding is based on the number and type of patients treated and the complexity of their care, incentivizing efficiency and ensuring that funding is tied to the actual care provided to patients. This funding model improves transparency, ensuring care is delivered at the right time and place as multiple organizations begin providing health services across the province.

“Exploring innovative ways to allocate funding within our health care system will ensure that Albertans receive the care they need, when they need it most. I am excited to see how this new approach will enhance the delivery of health care in Alberta.”

Adriana LaGrange, Minister of Health

Patient-focused, or activity-based, funding has been successfully implemented in Australia and many European nations, including Sweden and Norway, to address wait times and access to health care services, and is currently used in both British Columbia and Ontario in various ways.

“It is clear that we need a new approach to manage the costs of delivering health care while ensuring Albertans receive the care they expect and deserve. Patient-focused funding will bring greater accountability to how health care dollars are being spent while also providing an incentive for quality care.”

Dr. Chris Eagle, interim president and CEO, Acute Care Alberta

This transition is part of Acute Care Alberta’s mandate to oversee and arrange for the delivery of acute care services such as surgeries, a role that was historically performed by AHS. With Alberta’s government funding more surgeries than ever, setting a record with 304,595 surgeries completed in 2023-24 and with 310,000 surgeries expected to have been completed in 2024-25, it is crucial that funding models evolve to keep pace with the growing demand and complexity of services.

“With AHS transitioning to a hospital-based services provider, it’s time we are bold and begin to explore how to make our health care system more efficient and manage the cost of care on a per patient basis. The transition to a PFF model will align funding with patient care needs, based on actual service demand and patient needs, reflecting the communities they serve.”

Andre Tremblay, interim president and CEO, AHS

“Covenant Health welcomes a patient-focused approach to acute care funding that drives efficiency, accountability and performance while delivering the highest quality of care and services for all Albertans. As a trusted acute care provider, this model better aligns funding with outcomes and supports our unwavering commitment to patients.”

Patrick Dumelie, CEO, Covenant Health

“Patient-focused hospital financing ties funding to activity. Hospitals are paid for the services they deliver. Efficiency may improve and surgical wait times may decrease. Further, hospital managers may be more accountable towards hospital spending patterns. These features ensure that patients receive quality care of the highest value.”

Dr. Glen Sumner, clinical associate professor, University of Calgary

Leadership at Alberta Health and Acute Care Alberta will review relevant research and the experience of other jurisdictions, engage stakeholders and define and customize patient-focused funding in the Alberta context. This working group will also identify and run a pilot to determine where and how this approach can best be applied and implemented this fiscal year.

Final recommendations will be provided to the minister of health later this year, with implementation of patient-focused funding for select procedures across the system in 2026.

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Low oil prices could have big consequences for Alberta’s finances

Published on April 26, 2025

Todayville

From the Fraser Institute

By Tegan Hill

Amid the tariff war, the price of West Texas Intermediate oil—a common benchmark—recently dropped below US$60 per barrel. Given every $1 drop in oil prices is an estimated $750 million hit to provincial revenues, if oil prices remain low for long, there could be big implications for Alberta’s budget.

The Smith government already projects a $5.2 billion budget deficit in 2025/26 with continued deficits over the following two years. This year’s deficit is based on oil prices averaging US$68.00 per barrel. While the budget does include a $4 billion “contingency” for unforeseen events, given the economic and fiscal impact of Trump’s tariffs, it could quickly be eaten up.

Budget deficits come with costs for Albertans, who will already pay a projected $600 each in provincial government debt interest in 2025/26. That’s money that could have gone towards health care and education, or even tax relief.

Unfortunately, this is all part of the resource revenue rollercoaster that’s are all too familiar to Albertans.

Resource revenue (including oil and gas royalties) is inherently volatile. In the last 10 years alone, it has been as high as $25.2 billion in 2022/23 and as low as $2.8 billion in 2015/16. The provincial government typically enjoys budget surpluses—and increases government spending—when oil prices and resource revenue is relatively high, but is thrown into deficits when resource revenues inevitably fall.

Fortunately, the Smith government can mitigate this volatility.

The key is limiting the level of resource revenue included in the budget to a set stable amount. Any resource revenue above that stable amount is automatically saved in a rainy-day fund to be withdrawn to maintain that stable amount in the budget during years of relatively low resource revenue. The logic is simple: save during the good times so you can weather the storm during bad times.

Indeed, if the Smith government had created a rainy-day account in 2023, for example, it could have already built up a sizeable fund to help stabilize the budget when resource revenue declines. While the Smith government has deposited some money in the Heritage Fund in recent years, it has not created a dedicated rainy-day account or introduced a similar mechanism to help stabilize provincial finances.

Limiting the amount of resource revenue in the budget, particularly during times of relatively high resource revenue, also tempers demand for higher spending, which is only fiscally sustainable with permanently high resource revenues. In other words, if the government creates a rainy-day account, spending would become more closely align with stable ongoing levels of revenue.

And it’s not too late. To end the boom-bust cycle and finally help stabilize provincial finances, the Smith government should create a rainy-day account.

Alberta

Governments in Alberta should spur homebuilding amid population explosion

Published on April 26, 2025

Todayville

From the Fraser Institute

By Tegan Hill and Austin Thompson

In 2024, construction started on 47,827 housing units—the most since 48,336 units in 2007 when population growth was less than half of what it was in 2024.

Alberta has long been viewed as an oasis in Canada’s overheated housing market—a refuge for Canadians priced out of high-cost centres such as Vancouver and Toronto. But the oasis is starting to dry up. House prices and rents in the province have spiked by about one-third since the start of the pandemic. According to a recent Maru poll, more than 70 per cent of Calgarians and Edmontonians doubt they will ever be able to afford a home in their city. Which raises the question: how much longer can this go on?

Alberta’s housing affordability problem reflects a simple reality—not enough homes have been built to accommodate the province’s growing population. The result? More Albertans competing for the same homes and rental units, pushing prices higher.

Population growth has always been volatile in Alberta, but the recent surge, fuelled by record levels of immigration, is unprecedented. Alberta has set new population growth records every year since 2022, culminating in the largest-ever increase of 186,704 new residents in 2024—nearly 70 per cent more than the largest pre-pandemic increase in 2013.

Homebuilding has increased, but not enough to keep pace with the rise in population. In 2024, construction started on 47,827 housing units—the most since 48,336 units in 2007 when population growth was less than half of what it was in 2024.

Moreover, from 1972 to 2019, Alberta added 2.1 new residents (on average) for every housing unit started compared to 3.9 new residents for every housing unit started in 2024. Put differently, today nearly twice as many new residents are potentially competing for each new home compared to historical norms.

While Alberta attracts more Canadians from other provinces than any other province, federal immigration and residency policies drive Alberta’s population growth. So while the provincial government has little control over its population growth, provincial and municipal governments can affect the pace of homebuilding.

For example, recent provincial amendments to the city charters in Calgary and Edmonton have helped standardize building codes, which should minimize cost and complexity for builders who operate across different jurisdictions. Municipal zoning reforms in Calgary, Edmonton and Red Deer have made it easier to build higher-density housing, and Lethbridge and Medicine Hat may soon follow suit. These changes should make it easier and faster to build homes, helping Alberta maintain some of the least restrictive building rules and quickest approval timelines in Canada.

There is, however, room for improvement. Policymakers at both the provincial and municipal level should streamline rules for building, reduce regulatory uncertainty and development costs, and shorten timelines for permit approvals. Calgary, for instance, imposes fees on developers to fund a wide array of public infrastructure—including roads, sewers, libraries, even buses—while Edmonton currently only imposes fees to fund the construction of new firehalls.

It’s difficult to say how long Alberta’s housing affordability woes will endure, but the situation is unlikely to improve unless homebuilding increases, spurred by government policies that facilitate more development.