A New Backbone for Health Care — Or Just A New Name

Alberta’s health care system is undergoing a significant structural evolution. With the introduction of Health Shared Services (HSS), officially launched on December 1, 2025, the Government of Alberta has created an entity to provide services to clinical and non-clinical teams across the province’s health care system.

Health Shared Services, a Provincial Health Corporation, is responsible for delivering and coordinating corporate and support services related to the administration and operation of the health care system, with a budget of $2.3 billion.

With the dismantling of Alberta Health Services (AHS) as part of the larger health reorganization and the creation of Health Shared Services, the change is positioned as transformative but could reflect more focused administrative change.

Although the budgets of these two entities, AHS and HSS, are entirely different, at approximately $34.4 billion vs. $2.4 billion, respectively, the functions and roles appear to have overlap.

What Was Alberta Health Services?

AHS was one of the largest integrated health systems in North America. It consolidated multiple regional health authorities into a single, province-wide entity responsible for:

• Delivering frontline care (hospitals, clinics, continuing care)

• Managing public health programs • Overseeing workforce and clinical operations

• Providing centralized support services (IT, procurement, labs, etc.)

AHS combined both service delivery and support within a single organization.

What Is Health Shared Services?

HSS represents a functional reorganization of Alberta’s health care system. Rather than one entity managing all aspects of care, the system is being broken into specialized organizations, with shared services acting as a backbone.

While still evolving, Health Shared Services will generally focus on:

• Procurement and supply chain management

• Information technology and digital infrastructure

• Finance, HR, and administrative services

• Laboratory and diagnostic coordination (in some models)

These services support multiple health care delivery organizations, rather than being embedded within one.

HSS separates support functions from direct care delivery.

Key Similarities

Despite structural changes, there are important continuities including centralized support functions, province-wide scope, and government oversight.

Both models recognize the value of centralized services like procurement, IT, and HR to reduce duplication, achieve economies of scale, and standardize processes across the province.

Both AHS and HSS operate at a provincial level, ensuring consistency in service access, coordinated planning and investment, and the ability to leverage provincial scale.

In both systems, the provincial government maintains strategic control, funding authority, and policy direction.

Key Differences

The most important distinctions relate to structure, accountability, and flexibility. AHS was a fully integrated model with one organization delivering care and managing support services, whereas HSS acts in a more modular fashion with separate entities for care delivery and support. This difference reflects the shift from a single operator model to a multi-organizational system.

Another key difference is in the focus and specialization of each. AHS had a broad mandate across all aspects of health care, whereas HSS has a narrower and specialized mandate focused on efficiency and support services. HSS acts as a provider to the system rather than a system operator.

The accountability and governance of each organization also differ significantly, with AHS having a single leadership structure accountable for both clinical and operational outcomes, while HSS supports multiple organizations with distinct leadership and accountability frameworks.

Lastly, AHS had a very integrated model with the goal of reducing fragmentation with an increase in bureaucracy, whereas HSS introduces an increased risk of silos between organizations if coordination is weak.

If the goal of this change is to build a system that is more responsive to patient needs, more efficient in its use of resources, and better positioned for innovation and growth, HSS will need to focus on the coordination of a new, networked ecosystem of health entities.

The ultimate success of this transition will depend on execution, emphasizing integration across multiple entities rather than integration within one.