Promoting Equitable Funding and Sustainability for Community-Based Primary Care

Issue

Access to timely and effective healthcare is essential in building community well-being and economic stability, especially in rural communities with limited primary healthcare access. In Alberta, Nurse Practitioners (NPs) are vital in delivering primary care; however, current funding models limit their ability to practice effectively by failing to provide equivalent career security to their MD counterparts and NP equivalents practicing in AHS facilities. To ensure long-term healthcare stability, Alberta must provide a predictable, equitable framework that allows Nurse Practitioners (NPs), physicians, and nurse-owned clinics to operate as viable small businesses.

Background

This policy must support NP-owned and nurse-owned primary care clinics, including those owned by Registered Nurses that employ NPs and other regulated providers to ensure equitable funding for all community-based, nurse-run practices delivering longitudinal primary care. NP-led and nurse-owned clinics operate as small businesses that carry the same overhead and staffing responsibilities as physician clinics and require equivalent, predictable funding models to remain viable in rural and urban communities alike.

Recommendations

The Alberta Chambers of Commerce recommends that the Government of Alberta:

1. Ensure Primary Care Financial Viability through Compensation Equity: Implement an equitable fee schedule and billing codes for Authorized Primary Care Practitioners that reflect their full scope of practice. These codes must ensure proportional compensation parity across disciplines to ensure that independent clinics are financially viable and
   sustainable small businesses. Funding models should recognize and compensate practitioners for services provided to non-paneled patients so clinics are not penalized for meeting urgent and episodic care needs, modeled after the successful frameworks in Ontario35 (Bill 13) and Saskatchewan36.
2. Implement a Tiered Practice Establishment Grant: Replace outdated or expiring flat-rate overhead allowances with a tiered Practice Establishment Grant, modeled after successful recruitment incentives in New Brunswick and Saskatchewan. This grant should support early-career professionals or those establishing new practices in underserved areas,
   providing a one-time conditional capital startup grant (e.g., $50,000 for urban and $75,000 for rural) to offset EMR implementation, leasehold improvements, and medical equipment costs.
3. Streamline Administrative and Regulatory Burdens: Align financial oversight requirements for NP-led and nurse-owned clinics with those of physician-led practices. Replace mandatory third-party annual audited financial reports with standard billing audits and tax compliance mechanisms. Replacing these audits with standard compliance mechanisms will reduce administrative overhead, allowing clinics to redirect those funds toward direct patient care and staffing, ultimately reducing wait times. Additionally, adjust NPPCP hour requirements and panel size targets to be realistic for providers serving high-complexity patients or those operating in low-density rural environments.