Alberta is rolling the dice on a controversial new funding approach that could fundamentally reshape how hospitals allocate resources — but the gamble is drawing scrutiny from health policy experts who worry it may make surgical wait times worse, not better.
The province recently launched patient-focused funding for hip and knee replacements, cataract surgeries and shoulder repairs across 12 public hospitals. Under this model, hospitals receive payment based on the volume and complexity of procedures they perform, rather than receiving fixed annual budgets regardless of output.
Premier Danielle Smith has championed the initiative as a path to greater hospital efficiency and accountability. "It rewards hospitals for treating more patients instead of making every patient a cost," she said at a recent news conference. "It's a system that is transparent. It shows taxpayers where their money is going, and it means we can hold hospitals accountable."
The government plans to expand this funding model to all public hospitals and additional surgical categories in coming phases.
The Hidden Cost of Chasing Numbers
While the concept sounds promising on paper, health system veterans are raising red flags about Alberta's execution. Stacey Litvinchuk, a former senior program officer for surgery operations at Alberta Health Services, acknowledged the funding-follows-patient concept has merit — but warned that implementation could be disastrous in a health-care system already stretched thin.
"I think it could put the system further at risk," Litvinchuk said. "When hospitals do more volume on these simpler procedures, it's going to pull resources away from other complex surgical procedures and other complex care within the hospital."
The concern is straightforward: hospitals facing pressure to maximize revenue from high-volume procedures like hip replacements and cataract surgeries may quietly redirect staff, operating room time and equipment away from lower-volume but critical services — cancer surgeries, cardiac procedures, and emergency operations. Albertans already struggling with surgical wait times that exceed clinical guidelines could face even longer delays for life-threatening conditions.
"When they do more volume, it's going to pull resources away from other complex surgical procedures [and] other complex care within a hospital." — Stacey Litvinchuk, former Alberta Health Services surgery operations lead
B.C. and Quebec Already Moving Away from This Model
Notably, British Columbia and Quebec have both stepped back from similar patient-focused funding systems, suggesting Alberta may be learning lessons other provinces have already discovered the hard way.
The Alberta government insists the plan includes safeguards. Press secretary Maddison McKee said hospitals retain full authority over clinical priorities and resource allocation. "Patient complexity is explicitly built into the funding formula," McKee stated in an email. "What changes is the funding mechanism, not the clinical priorities that govern care."
However, Litvinchuk and other experts remain skeptical that good intentions will survive contact with budget pressures in underfunded hospital systems. The question looming over Alberta's health-care sector is whether this experiment will unlock efficiency — or simply shift the pain from common procedures to critically ill patients waiting for complex surgeries.
This article is based on reporting from CBC News.