The Tribune

By NATARIO McKENZIE

Tribune Business Reporter

nmckenzie@tribunemedia.net

The contract to manage the National Health Insurance (NHI) scheme’s public insurer could be concluded “in the coming days”, its project manager yesterday saying doctors will temporarily be paid directly via the NHI Authority.

Dr Delon Brennen, speaking with Tribune Business following the first NHI patient visit yesterday, acknowledged that negotiations with Family Guardian and its international partner, Aetna, had “advanced’” to the contract stage.  

“Negotiations have advanced to the point where we think we are able to go into contract with them,” he said. “Obviously it’s not on us because that’s a contract with central government as a whole to run the public insurer, but my understanding is that they have reached a point where both sides feel as though they are close enough to sign a contract that, within the coming days, that will be concluded.”

Dr Brennen explained that despite the public insurer not yet being in place, the NHI Authority - the overseer for the scheme - will be the initial mechanism through which doctors will receive payment based on the capitation method. 

“The issue isn’t that we need the public insurer in place to deliver payment,” Dr Brennen said. “What is important is that we have a payment mechanism in order to deliver that.

“Right now, the NHI Authority is going to be the mechanism by which the providers actually get paid. Once the regulated health administrators (RHA) are in place, the expectation is that the NHI Authority would basically take the per capita adjusted amount for each patient per year, deliver that to the RHAs along with an administration fee, and the RHAs would then make payments to providers so payments no longer come directly from NHI or the NHI Authority, but through the RHAs, who would then become the co-ordinators  of benefits for the individual beneficiaries and make payments to providers based on when and how patients are being seen.”

RHAs are supposed to be the private health insurance companies, but none have yet to agree to participate in NHI, and little dialogue is understood to have occurred between the Government and the sector in recent months.

But according to Dr Brennen, the roll-out of NHI “is going extremely well; even better than we would have expected”.

He added: “Today we have almost 9,000 people who have enrolled so far in only just over a week.  We are definitely progressing very well to getting Bahamians modern, affordable and accessible care that they have been asking for for years. 

“We have been working on this for the greater part of three decades. Initially we had signed up in excess of 60 of our private providers, and now we are in excess of 100 providers total who would have been able to get on to the programme.”