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Alberta

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

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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.

Alberta

Premier Smith: Canadians support agreement between Alberta and Ottawa and the major economic opportunities it could unlock for the benefit of all

Published on

From Energy Now

By Premier Danielle Smith

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If Canada wants to lead global energy security efforts, build out sovereign AI infrastructure, increase funding to social programs and national defence and expand trade to new markets, we must unleash the full potential of our vast natural resources and embrace our role as a global energy superpower.

The Alberta-Ottawa Energy agreement is the first step in accomplishing all of these critical objectives.

Recent polling shows that a majority of Canadians are supportive of this agreement and the major economic opportunities it could unlock for the benefit of all Canadians.

As a nation we must embrace two important realities: First, global demand for oil is increasing and second, Canada needs to generate more revenue to address its fiscal challenges.

Nations around the world — including Korea, Japan, India, Taiwan and China in Asia as well as various European nations — continue to ask for Canadian energy. We are perfectly positioned to meet those needs and lead global energy security efforts.

Our heavy oil is not only abundant, it’s responsibly developed, geopolitically stable and backed by decades of proven supply.

If we want to pay down our debt, increase funding to social programs and meet our NATO defence spending commitments, then we need to generate more revenue. And the best way to do so is to leverage our vast natural resources.

At today’s prices, Alberta’s proven oil and gas reserves represent trillions in value.

It’s not just a number; it’s a generational opportunity for Alberta and Canada to secure prosperity and invest in the future of our communities. But to unlock the full potential of this resource, we need the infrastructure to match our ambition.

There is one nation-building project that stands above all others in its ability to deliver economic benefits to Canada — a new bitumen pipeline to Asian markets.

The energy agreement signed on Nov. 27 includes a clear path to the construction of a one-million-plus barrel-per-day bitumen pipeline, with Indigenous co-ownership, that can ensure our province and country are no longer dependent on just one customer to buy our most valuable resource.

Indigenous co-ownership also provide millions in revenue to communities along the route of the project to the northwest coast, contributing toward long-lasting prosperity for their people.

The agreement also recognizes that we can increase oil and gas production while reducing our emissions.

The removal of the oil and gas emissions cap will allow our energy producers to grow and thrive again and the suspension of the federal net-zero power regulations in Alberta will open to doors to major AI data-centre investment.

It also means that Alberta will be a world leader in the development and implementation of emissions-reduction infrastructure — particularly in carbon capture utilization and storage.

The agreement will see Alberta work together with our federal partners and the Pathways companies to commence and complete the world’s largest carbon capture, utilization and storage infrastructure project.

This would make Alberta heavy oil the lowest intensity barrel on the market and displace millions of barrels of heavier-emitting fuels around the globe.

We’re sending a clear message to investors across the world: Alberta and Canada are leaders, not just in oil and gas, but in the innovation and technologies that are cutting per barrel emissions even as we ramp up production.

Where we are going — and where we intend to go with more frequency — is east, west, north and south, across oceans and around the globe. We have the energy other countries need, and will continue to need, for decades to come.

However, this agreement is just the first step in this journey. There is much hard work ahead of us. Trust must be built and earned in this partnership as we move through the next steps of this process.

But it’s very encouraging that Prime Minister Mark Carney has made it clear he is willing to work with Alberta’s government to accomplish our shared goal of making Canada an energy superpower.

That is something we have not seen from a Canadian prime minister in more than a decade.

Together, in good faith, Alberta and Ottawa have taken the first step towards making Canada a global energy superpower for benefit of all Canadians.

Danielle Smith is the Premier of Alberta

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Alberta

A Memorandum of Understanding that no Canadian can understand

Published on

From the Fraser Institute

By Niels Veldhuis

The federal and Alberta governments recently released their much-anticipated Memorandum of Understanding (MOU) outlining what it will take to build a pipeline from Alberta, through British Columbia, to tidewater to get more of our oil to markets beyond the United States.

This was great news, according to most in the media: “Ottawa-Alberta deal clears hurdles for West Coast pipeline,” was the top headline on the Globe and Mail’s website, “Carney inks new energy deal with Alberta, paving way to new pipeline” according to the National Post.

And the reaction from the political class? Well, former federal environment minister Steven Guilbeault resigned from Prime Minister Carney’s cabinet, perhaps positively indicating that this agreement might actually produce a new pipeline. Jason Kenney, a former Alberta premier and Harper government cabinet minister, congratulated Prime Minister Carney and Premier Smith on an “historic agreement.” Even Alberta NDP Leader Naheed Nenshi called the MOU “a positive step for our energy future.”

Finally, as Prime Minister Carney promised, Canada might build critical infrastructure “at a speed and scale not seen in generations.”

Given this seemingly great news, I eagerly read the six-page Memorandum of Understanding. Then I read it again and again. Each time, my enthusiasm and understanding diminished rapidly. By the fourth reading, the only objective conclusion I could reach was not that a pipeline would finally be built, but rather that only governments could write an MOU that no Canadian could understand.

The MOU is utterly incoherent. Go ahead, read it for yourself online. It’s only six pages. Here are a few examples.

The agreement states that, “Canada and Alberta agree that the approval, commencement and continued construction of the bitumen pipeline is a prerequisite to the Pathways project.” Then on the next line, “Canada and Alberta agree that the Pathways Project is also a prerequisite to the approval, commencement and continued construction of the bitumen pipeline.”

Two things, of course, cannot logically be prerequisites for each other.

But worry not, under the MOU, Alberta and Ottawa will appoint an “Implementation Committee” to deliver “outcomes” (this is from a federal government that just created the “Major Project Office” to get major projects approved and constructed) including “Determining the means by which Alberta can submit its pipeline application to the Major Projects Office on or before July 1, 2026.”

What does “Determining the means” even mean?

What’s worse is that under the MOU, the application for this pipeline project must be “ready to submit to the Major Projects Office on or before July 1, 2026.” Then it could be another two years (or until 2028) before Ottawa approves the pipeline project. But the MOU states the Pathways Project is to be built in stages, starting in 2027. And that takes us back to the circular reasoning of the prerequisites noted above.

Other conditions needed to move forward include:

The private sector must construct and finance the pipeline. Serious question: which private-sector firm would take this risk? And does the Alberta government plan to indemnify the company against these risks?

Indigenous Peoples must co-own the pipeline project.

Alberta must collaborate with B.C. to ensure British Columbians get a cut or “share substantial economic and financial benefits of the proposed pipeline” in MOU speak.

None of this, of course, addresses the major issue in our country—that is, investors lack clarity on timelines and certainty about project approvals. The Carney government established the Major Project Office to fast-track project approvals and provide greater certainty. Of the 11 project “winners” the federal government has already picked, most either already had approvals or are already at an advanced stage in the process. And one of the most important nation-building projects—a pipeline to get our oil to tidewater—hasn’t even been referred to the Major Project Office.

What message does all this send to the investment community? Have we made it easier to get projects approved? No. Have we made things clearer? No. Business investment in Canada has fallen off a cliff and is down 25 per cent per worker since 2014. We’ve seen a massive outflow of capital from the country, more than $388 billion since 2014.

To change this, Canada needs clear rules and certain timelines for project approvals. Not an opaque Memorandum of Understanding.

Niels Veldhuis

President, Fraser Institute
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