BHeC reveals plan for value-based system


Bermuda’s health watchdog has released an information brief as part of a push towards a value-based healthcare system.

A spokeswoman for the Bermuda Health Council said that alternative payment mechanisms could be used to “reimburse the delivery of health services, better incentivise collaboration, and move closer to universal health coverage”.

She added that the information provided in the brief “is part of a larger community conversation around goals for transitioning our system from a volume-based payment model to one based more on value”.

The spokeswoman said that the price Bermudians are paying for health insurance had continued to rise.

She added: “When paired with the high incidence of chronic illness and an ageing population with growing healthcare needs, we are faced with the task of supporting the allocation of resources necessary to achieve better outcomes, while still improving affordability for the public.”

The spokeswoman said that the healthcare system should be balanced to ensure that patient care needs are met and that healthcare providers are “fairly and appropriately” reimbursed.

She added: “The right payment mechanism encourages providers to offer necessary, cost-effective care without compromising quality, and also ensures that prevention is covered and wellness is prioritised.”

Annabel Fountain, the president of the Bermuda Medical Doctors Association, said that volume-based reimbursement was sometimes linked to medically unnecessary work, including lab tests, diagnostic imaging and surgeries.

She added: “These systems are very expensive and often do not support preventive care and can even do more harm.”

Dr Fountain said that value-based systems weighed service outcomes, including patient satisfaction, reduced hospital readmission rates and wait times, and reduced complication rates.

She added: “Incentives are applied to encourage cost-effective practices, while supporting quality outcomes.”

Dr Fountain said: “Unfortunately, not all outcomes are based on the quality of the care received.”

She explained that many outcomes are based on other factors including socio-economics, genetics, and psychological and mental health.

Dr Fountain said: “We are concerned that this might not be acknowledged. However, audit of clinical processes can provide evidence that clinical guidelines have been followed, supporting reimbursement even if the outcome is not optimal.”

The brief can be seen on the Bermuda Health Council website at bhec.bm/fact-sheets.

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Published Feb 13, 2019 at 8:00 am (Updated Feb 13, 2019 at 8:00 am)

BHeC reveals plan for value-based system

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