The Tribune

By TANYA SMITH-CARTWRIGHT

tsmith-cartwright@tribunemedia.net

THE National Health Insurance Authority has announced plans to expand its primary care services.

“I am pleased to announce that today, the National Health Insurance Authority sets out to expand our primary care services, both in quality and quantity,” said Dr Robin Roberts, chairman of the NHI Authority, during a virtual press conference yesterday. “In my over 30 years’ experience of practising medicine in The Bahamas, this promises to be the most transformative initiative in the history of our health care system.

“Since the launch of NHI Bahamas in April 2017, nearly 90,000 beneficiaries are enrolled in the programme with high levels of satisfaction reported by persons who are currently receiving primary care services.

“While we have been hearing positive feedback about NHI so far, the government of The Bahamas seeks to continue its efforts to deliver on the triple goal of healthcare: to better the patient experience, to improve the health conditions of our people, and to get the best quality services and value for the money we spend on health,” Dr Roberts said.

“This next phase of NHI will bring together the public and private healthcare delivery networks under a common and comprehensive model of care that improves quality, consistency of experience, and access to primary healthcare services without any cost at the point of service.

“NHI has already made significant progress in this objective. The Primary Care Transformation Initiative, when implemented, will complete the process.”

A timeline for the new initiative was not announced as officials are still in the consultation phase before final recommendations are presented to the government.

However, Dr Roberts said a revised standard healthcare benefit will be available for all Bahamians who enrol with the Primary Care Transformation Initiative for no additional copays or deductibles, ensuring high quality primary healthcare is delivered throughout the nation.

“The revised standard healthcare benefit is a package of services that encompasses primary healthcare coverage and includes all primary healthcare physician visits as into this care will be specific paediatric and maternity coverage which covers all evidenced-based best practices for antenatal and newborn care, including all lab tests, imaging and immunizations associated with best outcomes,” he continued.

“This public private integration allows those in private health insurance to access the standard healthcare benefit without paying co-pays or deductibles. A most integral part of our NHI primary care services is our single primary care electronic health record (EHR). This allows for telemedicine services and a patient portal that allows patients to access their records and book appointments online.”

The National Health Insurance Authority released a policy paper, entitled “Primary Care Transformative Initiative”, which outlines the proposed policy framework.

Dr Roberts said under the new proposal, NHI promises to be affordable, realistic, and sustainable, with a goal to act as a catalyst for change in the way Bahamians experience health care.

The Primary Care Transformative Initiative is said to benefit Bahamians in the following ways:

Accessibility: The PCTI will allow access for every Bahamian to a dedicated primary healthcare physician, building a digitally enabled patient-physician relationship with a focus on preventative medicine and health education.

Quality: Both public and private clinics will be required to adhere to a high standard of quality in healthcare through provider agreements, with patient centric funding and high quality data infrastructure enabled through the EHR.

Affordability: The PCTI is an important step to protect those who have pre-existing conditions and were previously unable to obtain insurance for primary care coverage. This model allows for private insurers to keep premiums low by limiting an insurer’s exposure to fee-for-service events and fairly compensates physicians through a negotiated capitation arrangement based on multiple factors, including patient risk.

Economically: Through integration of the primary care system, the PCTI is expected to save taxpayers more than $55m over the next five years by removing duplication and inefficiency from the system. This will create fiscal room for needed investment into our communities. Further, without having to impose new taxes or funding mechanisms like an employer mandate, the PCTI will keep our business community competitive.

The NHI Authority also launched its electronic health records system which, the Authority said will be handled with the strictest confidentiality, giving those enrolled access to their records.