Leaders in the insurance field have come out in full support of proposed changes to the medical billing system outlined in the Johns Hopkins Report.

The Johns Hopkins Medicine International Report was released by the Health Minister Nelson Bascome on Friday six months after it was published by the international organisation.

The document outlines three areas of concern before rebuilding of the King Edward VII Memorial Hospital.

"The first of the discussed key determining factors — nonacute care, reimbursement system and length of stay — are significant; each working independently as well as collectively will influence the size and therefore the cost of the facility," it says.

Changes in the reimbursement system include moving from the current per diem billing to a case-by-case situation, much like the United States and the United Kingdom.

These changes were applauded by Cindy Campbell, group insurance executive vice president of the Argus Group who said the company was ready for the changes.

She said: "Argus is very comfortable with case reimbursement as a method of payment, as we have paid many claims for hospital stays in the US under this system.

"Under case reimbursement a fixed charge is set for a particular medical condition regardless of how long a patient stays in hospital.

"If properly implemented, case reimbursement has the potential to reduce the length of hospital stays, which in turn could lead to lower costs, resulting in lower health insurance premiums."

Mr. Bascome in a statement to the House of Assembly on Friday said these changes had already gone more than well for outpatients at the KEMH and hoped to have inpatients' billing systems ready by April 2009.

He said: "The outpatient codes and descriptions successfully went live in 2007. BHB is now looking at inpatient coding, with the goal of implementing internationally recognised inpatient codes and descriptions by April 2009."

Holly Flook, BF&M's assistant vice president of health claims, was less certain the change would decrease lengths of stay or premium levels.

But she said the company had met with BHB officials last week and she hoped the new approach would help manage the insurance claims.

"It would make it more manageable from a claims volume perspective," she said. "A little bit easier to evaluate what types of services are being provided and allows us to have a bit more data and information.

"They (the BHB) have applied a number to a service but it's their own. (When it's introduced), we can look at all the (diagnosis-related group) DRG's in Bermuda and in the US and it will be comparing apples and apples.

"It's really going to help because we can see what the charges are."

However, before these changes can take place, the Johns Hopkins recommendations warned a larger community movement would be necessary.

Echoing these concerns, Ms Campbell said Argus encouraged residents on the Island to start taking preventative care to avoid future problems.

She said: "Of course, the best way for Bermudians to drive down the cost of healthcare is to take responsibility for their health and to live healthy lifestyles.

"As the first insurance company on the Island to offer a free wellness programme, we continue to focus our efforts toward promoting wellness as our commitment to containing the cost of healthcare."