Late last month, Alberta Health published data for 2021–2022 for payments the province made to physicians through the Alberta Health Care Insurance Plan.
The 2021–2022 Distribution of Physician and Allied Health Practitioner Payments and Services per Patient report tracks how many physicians there were in Alberta who received AHCIP payments, how much was paid out in total payments, how many “discrete patients”, and how many total services the physicians provided.
I thought I’d go through the data going back to 2014–2015 and see how things have changed. I had hoped to go back a full decade, but data older than that didn’t include the number of physicians.
First, here’s a look at the total number of physicians practicing in the province each year.
What we see here is that during the first 6 years, we saw a sustained upward trend on the number of physicians paid for services performed under AHCIP. And in 2021–2022, that number sat at its highest level ever.
However, something else that sticks out is a drop in physician numbers in 2020–2021, the only drop during this reporting period.
Oddly, this drop occurred during the first year of the COVID-19 pandemic, when you’d think if there would be a need for an increase in physicians, it’s be then.
Since we’re talking about change in numbers, let’s look at that more closely.
The largest increase in physicians was in the 2015–2016 budget year, which was also the first year that the NDP were in power, when we saw an increase of 409 physicians. No increase since then has come anywhere close to that, with the second highest being two years later at 329.
The 2020–2021 budget year, which I pointed out was the first year of the pandemic, was the only one that saw a decrease in physicians. And that means the increase of 127 physicians in 2021–2022 was actually a net increase of only 35 since 2019–2020, which is roughly 1/10th the increase we saw that year.
Here are the increases as percentages.
Pretty much the same pattern.
Now, let’s look at the total number of services performed by those physicians.
Unsurprisingly, we saw the number of services increase as the number of physicians increased. We also saw the reverse to be true in 2020–2021.
I think a more accurate assessment of these increases, however, would be to see whether the increase in doctors meant fewer services per doctor. So, here is the average number of services per doctor for each year.
Interestingly, we actually saw a couple of years with decreases: 2017–2018, as well as 2020–2021.
However, what really stuck out to me is the huge jump during the 2021–2022 budget year. Compared to the last year the NDP were in power, physicians were providing 328.18 more services each, on average, in 2021–2022. That’s a 5.5% increase.
No wonder doctors were saying they were feeling burned out during the pandemic.
Once again, we see the increases pretty consistent with the increase in physicians, with the only dip being in 2020–2021.
But check out the average cost per service for each year. Keep in mind that this is only for services covered under the fee-for-service agreement that the government signed with doctors.
Up until the UCP’s first year in power, how much the government paid physicians per service performed, on average, had been trending upward. However, that dropped nearly $4 per service to 2014–2015 levels the following year, also the first year of the pandemic.
The average payment for service recovered slightly the next year—the last year on record—but it was still well below levels seen under the NDP.
So, while we paid out more in total payments, the number of service also increased, but at a faster rate than the payment themselves.
Not only that, but the total number of services performed by physicians also increased faster than the number of patients being treated by those physicians.
So, we had fewer physicians during the first year of the pandemic seeing more patients, who themselves were receiving more services from doctors, and those doctors were being paid less for those services, on average.