NHI’s instant 170,000 expansion if go-ahead

The proposed National Health Insurance (NHI) scheme could rapidly expand to 160,000-170,000 beneficiaries once given the go-ahead due to technology reforms already in process.

Graham Whitmarsh, the National Health Insurance Authority’s (NHIA) chief executive and managing director, yesterday said its board had already selected a vendor to implement an Electronic Health Record (EHR) system that would record - and give doctors instant access to -all patient-related data in real time.

Addressing the Bahamas Business Outlook conference, Mr Whitmarsh described the EHR as “a fundamental piece of what we are doing” given its ability to improve healthcare efficiency while also cracking down on fraud and waste.

Suggesting that its implementation could be relatively seamless via NHI’s existing provider network, Mr Whitmarsh said: “Due to the fact that the physicians that work with NHI are under contract, we’re able to move forward and get an electronic record not just for the 47,000 beneficiaries that we have in today.

“If the Government decides to move forward with our proposals we will have 160,000 to 170,000 beneficiaries registered with NHI, all using the same electronic health record. We have been through an RFQ (qualification) process. The board has selected a final vendor and we’re in a position, if this goes forward, to move ahead with an electronic health record in April of this year.

“This is foundational to modern healthcare. Right now, healthcare is done here largely without quality programmes and without data. Getting this health record in place is the foundation to collect data that allows us to make evidence-based decisions. THE EHR is a fundamental piece of what we’re doing.”

Mr Whitmarsh said there are 80 providers serving the 47,000 beneficiaries enrolled in NHI, including physicians and laboratories in New Providence, Grand Bahama, Exuma and Abaco.

He described the state of Bahamian healthcare as “troubling”, noting that the annual spend just on dialysis treatment is over $30m year for 528 patients, with non-communicable diseases the leading causes of mortality in the country.

The NHI chief added that a KPMG study, examining a $100m investment in primary care, showed that it would add 4.8 percent to GDP, and $485m to the economy, by 2040.

“What we are proposing is actually more comprehensive, and one would expect bigger outcomes,” said Mr Whitmarsh, noting that less than 20 percent of the initially proposed $100m is going into the revised primary are scheme.

He added that consultation on the revised NHI package had been a “predominantly positive” experience. “There were only three individual organisations that we met that I would say had very negative views,” Mr Whitmarsh said.

“We heard a lot about the implementation timing, but also heard some say why wait so long? We heard a lot of discussion about who should pay. Employees felt employers should pay, employers felt employees should pay more, and everyone agreed the Government could pay more.”

He added that careful thought was given to the hospitality sector over how part-time and seasonal workers should be handled. Mr Whitmarsh said the ultimate decision rests with the Government on the way forward regarding the revised NHI scheme.