Alberta
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Alberta
Alberta takes big step towards shorter wait times and higher quality health care

From the Fraser Institute
ByĀ Nadeem Esmail
On Monday, the Smith government announced that beginning next year it will change the way it funds surgeries in Alberta. This is a big step towards unlocking the ability of Albertaās health-care system to provide more, better and faster services for the same or possibly fewer dollars.
To understand the significance of this change, you must understand the consequences of the current (and outdated) approach.
Currently, the Alberta government pays a lump sum of money to hospitals each year. Consequently, hospitals perceive patients as a drain on their budgets. From the hospitalās perspective, thereās little financial incentive to serve more patients, operate more efficiently and provide superior quality services.
Consider what would happen if your local grocery store received a giant bag of money each year to feed people. The number of items would quickly decline to whatever was most convenient for the store to provide. (Have a favourite cereal? Too bad.) Store hours would become less convenient for customers, alongside a general decline in overall service. This type of grocery store, like an Alberta hospital, is actually financially better off (that is, it saves money) if you go elsewhere.
The Smith government plans to flip this entire system on its head, to the benefit of patients and taxpayers. Instead of handing out bags of money each year to providers, the new systemāknown as āactivity-based fundingāāwill pay health-care providers for each patient they treat, based on the patientās particular condition and important factors that may add complexity or cost to their care.
This turns patients from a drain on budgets into a source of additional revenue. The result, as has been demonstrated in other universal health-care systems worldwide, is more services delivered using existing health-care infrastructure, lower wait times, improved quality of care, improved access to medical technologies, and less waste.
In other words, Albertans will receive far better value from their health-care system, which is currently among the most expensive in theĀ world. And relief canāt come soon enoughāfor example, last year in Alberta the median wait time for orthopedic surgeries including hip and knee replacements wasĀ 66.8 weeks.
The naysayers argue this approach will undermine the provinceās universal system and hurt patients. But by allowing a spectrum of providers to compete for the delivery of quality care, Alberta will follow the lead of other more successful universal health-care systems in countries such as Australia, Germany, the Netherlands and Switzerland and create greater accountability for hospitals and other health-care providers. Taxpayers will get a much better picture of what theyāre paying for and how much they pay.
Again, Alberta is not exploring an untested policy. Almost every other developed country with universal health care uses some form of āactivity-based fundingā for hospital and surgical care. And remember, we already spend more on health care than our counterparts in nearly all of these countries yet endure longer wait times and poorer access to services generally, in part because of how we pay for surgical care.
While the devil is always in the details, and while itās still possible for the Alberta government to get this wrong, Mondayās announcement is a big step in the right direction. A funding model that puts patients first will get Albertans more of the high-quality health care they already pay for in a timelier fashion. And provide to other provinces an example of bold health-care reform.
Alberta
Albertaās embrace of activity-based funding is great news for patients

From the Montreal Economic Institute
Albertaās move to fund acute care services through activity-based funding follows best practices internationally, points out an MEI researcher following an announcement made by Premier Danielle Smith earlier today.
āFor too long, the way hospitals were funded in Alberta incentivized treating fewer patients, contributing to our long wait times,ā explains Krystle Wittevrongel, director of research at the MEI. āInternational experience has shown that, with the proper funding models in place, health systems become more efficient to the benefit of patients.ā
Currently, Albertaās hospitals are financed under a system called āglobal budgeting.ā This involves allocating a pre-set amount of funding to pay for a specific number of services based on previous yearsā budgets.
Under the governmentās newly proposed funding system, hospitals receive a fixed payment for each treatment delivered.
AnĀ Economic NoteĀ published by the MEI last year showed that Quebecās gradual adoption of activity-based funding led to higher productivity and lower costs in the provinceās health system.
Notably, the province observed that the per-procedure cost of MRIs fell by four per cent as the number of procedures performed increased by 22 per cent.
In the radiology and oncology sector, it observed productivity increases of 26 per cent while procedure costs decreased by seven per cent.
āBeing able to perform more surgeries, at lower costs, and within shorter timelines is exactly what Albertaās patients need, and Premier Smith understands that,ā continued Mrs. Wittevrongel. āTodayās announcement is a good first step, and we look forward to seeing a successful roll-out once appropriate funding levels per procedure are set.ā
The governments expects to roll-out this new funding model for select procedures starting in 2026.
* * *
The MEI is an independent public policy think tank with offices in Montreal, Ottawa, and Calgary. Through its publications, media appearances, and advisory services to policymakers, the MEI stimulates public policy debate and reforms based on sound economics and entrepreneurship.
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