The NDP government is returning $90 million to Alberta doctors for helping the province cool the growth of health costs last year.

The repayment is required under the terms of a deal with the Alberta Medical Association in which a portion of doctors’ compensation was held back until the province was sure overall spending on physicians stayed on budget.

Distroscale

Had spending gone over budget, the province would have kept the money.

“We recognized that spending was going up and up, and that there needed to be a bend to the cost curve,” AMA president Dr. Neil Cooper said in a recent interview.

“The whole idea of putting some of our own money at risk in order to make those changes was something that was relatively new … and so physicians were willing to step up to the plate and were successful in doing so.”

The deal with the AMA was signed in late 2016 amid a period when spending to pay doctors was rising at an unsustainable eight per cent or nine per cent per year.

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Hoping to get that growth down to a more manageable rate, the pact called for the association and province to work together on several initiatives — including more judicious use of tests, changes to some doctors’ fees, a strategy to better control the influx of new doctors, and education around inappropriate billings.

As an insurance policy, doctors agreed to put some of their own pay on the line if spending continued to outpace the government’s budget.

For the 2016-17 fiscal year, physicians wound up losing their retention benefit, worth between $5,000 and $12,000 each depending on years of service.

For 2017-18, doctors were in line to lose their retention benefit again, as well as a cost of living increase worth about $4,000 on average.

However, overall spending on doctors came in slightly below the $5.2-billion budget, while growth was contained to about 1.6 per cent.

As such, the government is returning $90 million , enough for a partial repayment of the cost of living hike and retention benefit.

Cooper said it is hard to pinpoint why spending growth was better contained last year, since a number of factors could have played a role.

He noted a number of the initiatives included in the 2016 pact with the government have been at least partially implemented, while others are still a work in progress. External factors, including a possible decrease in new physicians coming into the Alberta system, may have also contributed significantly to the cooled spending.

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However, Cooper said he also believes a culture change has ignited among his colleagues around the idea that doctors have a responsibility to help the cash-strapped health system become more efficient.

“There was an attitude shift where people started to realize this was an area where we all needed to contribute and do things differently,” Cooper said.

Questions remain on how easy it will be to keep physician costs contained over the long term.

As a start, the AMA and province recently signed a new two-year compensation deal that features no fee increases. The province will also no longer pay a retention benefit, but did agree to continue funding several other doctor support programs.