Local Physicians To Discuss Healthcare Reform
A symposium for local physicians to discuss healthcare reform in Bermuda is taking place this Saturday 22 February at the Fairmont Southampton. “Healthcare Reform: Choosing Wisely for Quality and Sustainability” is a collaborative healthcare event, jointly produced by the Bermuda Health Council, the Ministry of Health and the Bermuda Hospitals Board.
The symposium will provide an opportunity for physicians to hear important information regarding Government’s vision for healthcare reform. This will include an assessment of current challenges facing the system, sustainability issues underlying the need for healthcare reform and proposals for potential reforms that address quality of care, patient safety and cost containment.
The meeting will also explore innovative care-delivery models and approaches to population-health management that are successfully employed in other jurisdictions. Four continuing medical education credits will be available to physicians who attend the full session.
Time has been allotted during each session for interactive discussion with the speakers. This provides physicians with an opportunity to share ideas and provide valuable feedback to policy decision-makers who work within Bermuda’s healthcare system.
The featured guest speaker is Dr Jeffrey Brenner, an American physician who is working to control healthcare costs through patient engagement. Dr Brenner founded the Camden Coalition of Healthcare Providers in New Jersey, in order to establish a new way for hospitals, healthcare providers and community residents to collaborate on health.
As the Coalition’s Executive Director, Dr Brenner meets with stakeholders and policymakers, advocating for models of care the Coalition has developed and demonstrated through evidenced-based results. Dr. Brenner is a 2013 MacArthur Foundation Fellow. Dr. Atul Gawande wrote about Dr. Brenner’s work in “The Hot Spotters,” an article published in The New Yorker magazine, 24 January 2011.
Bermudian Dr. Victor Scott, an internist specializing in gastroenterology and the retired senior vice president for health sciences at Howard University, will moderate the symposium. Dr. Scott recently served as the interim Chief of Staff at BHB.
Other presenters include:
- Minister of Health Trevor Moniz: Healthcare Reform in Bermuda: Improving Population Health, Ensuring Quality and Achieving Cost Containment
- CEO of the Bermuda Health Council, Dr Jennifer Attride-Sterling: Healthcare Financing, the Need for Cost Containment and Strategies for a Healthier System
- Interim CFO for Bermuda Hospitals Board, Mr David Thompson: Hospital Financing and Sustainability
- Dr. Victor Scott: Utilization Management: Its Role in Containing Healthcare Costs
- Medical Director, American Health Holding, Dr Roland Griggs: The Science Behind Care Guidelines
- Medical Director, Health Services Authority and Chief Medical Officer, Cayman Islands, Dr Delroy Jefferson: Implementing Pre-Certification in the Cayman Islands: Our Experience
- Panel Discussion on Utilization Management: Dr Griggs, Dr Jefferson and Dr Joanna Sherratt Wyer, President, Bermuda Medical Doctors Association
- Chief of Staff of Bermuda Hospitals Board, Dr Michael Weitekamp and Dr. Victor Scott: Changing Payment Models in Healthcare Delivery
Minister of Health, Trevor Moniz comments, “This symposium gives physicians a chance to discuss where we are heading as a healthcare system and the best ways for Bermuda to develop a more efficient service, one which provides better clinical outcomes for patients, and helps control rising premiums.
“This is a unique opportunity for physicians to be a part of reform in Bermuda, as we seek to better manage utilisaton and build healthier communities. These are serious issues to be addressed. As a country and as individuals, we cannot afford the current cost of healthcare. There are better ways to coordinate, cooperate and collaborate that will reduce costs and benefit the people who matter most – the people in Bermuda. I am inviting physicians to help shape the way ahead.”
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Gov has been making noise re requiring precertification for medical procedures. LOL thanks but I prefer my Doctor to make judgements on what tests I require, not a civil servant.
If there is one item that is driving up the costs of healthcare in Bermuda, it is not the doctors, it is that huge white elephant addition to KEMH whose costs could bankrupt the country.
I too would like my doctor to decide what tests I need, but as a large employer on the Island we have experienced double digit increases in our healthcare premiums for several years in a row, which is simply not sustainable in an economy where revenue growth is anemic.
If we don’t find a way to stem the inflation of healthcare costs very soon then other difficult decisions will have to be made as to how to offset those costs by either paring down the breadth of coverage or lowering personnel costs in other areas.
I’m guessing that most employees would prefer some sort of precertification requirement to facing substantial loss of health benefits or even job loss.
Dr. West from St. George thankfully is not on the panel.
After the letter I received from him, on his stationery endorsing Nandi Davis, from his office constituency of #2- It would be difficult for the public of trust his instincts.
Red herring.
OBAers will call you a hater, but I heard the same about the good old doctor. I would never go to him for this unethical behavior. On his business letterhead? Not good, is that a breach sending to his patients.?
As I understand it, precertification never stops a doctor from choosing a patient’s treatment, it just puts into place guidelines which aim to control over-use of certain things like MRI scans. So if a patient has already had two scans, the doctor will be questioned when he/she orders a third for the same person.
From what I have read, there is also nothing to stop a patient going ahead with the treatment, it’s just that they may have to pay the full cost themselves.
I see no harm in that at all. Health care costs are a major issue in Bda – for a lot of people there will come a time when they are not affordable, ie when they retire, unless controls are put in place now.
The building at KEMH is not really the issue here, it is the overuse of tests – a report recently said that 56percent of MRI scans etc at the hospital came from requests by doctors. That is not a sustainable practice.
I am seriously worried about being able to retire here if the cost of healthcare is not curbed. Putting in place guidelines and practices – that already exist in the rest of the world – does no harm.
There is a serious disconnect between pricing of healthcare in Europe, UK, Canada, USA & Bermuda. There is a a rampant abuse of overcharging for testing, doctors visits, drugs in Bermuda. Blood test costs at the hospital are outrageous…..1000% more than in the USA in some cases. The doctors, the drug suppliers etc simply pass on the “CHARGE” to the Health Insurance Companies…..who PAY UP. Health Care is through the roof in BERMUDA. People should be freaked out about this. All the Bermuda Health Insurers need to PROTECT their clients from the over charging of doctors and drug stores, by refusing to pay for obscene billings. Plus the clients need to be INFORMED of the fees up front. This “INSURANCE COMPANY WILL PAY” nonsense has to stop, I am not saying ALL doctors abuse the system, but it has gotten OUT of HAND. HEALTH INSURANCE is insane in BERMUDA……Enough is Enough
Archie,
I must raise my concerns on a couple of issues. Firstly, let me say that I hope that 100% of tests at KEMH are ordered by physicians, not the 56% you stated.
The Bermuda Medical Doctors’ Association (of which I am the President) represents physicians on the island, and we recognize that the escalating costs of healthcare are totally unsustainable. However, we are extremely keen to avoid pre-certification. The aim of this, as stated by the government, puts mechanisms into place that will requires that doctors require pre-authorization for tests that they request. At the moment, it seems that this is limited to CT and MRI requests, but may well spread to include other services.
The issue here is that this comes at a cost. Someone will have to pay the costs of having a system that can implement pre-certification. Staff will need to be hired – both by the insurance companies and by the doctors, in order to deal with the requisite paperwork. The cost of these tests will be born by the patients – whether in the form of higher premiums, or higher co-pays at the physician’s offices.
Not only are we worried about the costs to our patients, but we are also worried about delays incurred by using such a system, and the legal ramifications that will happen if the test requested is refused. If I order a test on a patient, it is because I truly believe it is a necessary one. If I believe that a patient needs a CT or an MRI scan, and it is refused, but that individual is later found to have a medical condition which could have been treated if caught earlier (such as cancer), then who is responsible?
The government is aiming to save $6 million dollars by introducing pre-certification. They have not declared how much implementing it is going to cost. And to put it in perspective, $6 million is less than 1% of the total healthcare spend in Bermuda (which is over $679 million).
Of course, it sounds appealing – we all want the best in healthcare for our patients, but this is not shown to improve healthcare. The BMDA is much more interested in implementing appropriate guidelines for guiding treatment of patients, ensuring that physicians across the board are giving the best care they can, looking at ways to avoid the unnecessary duplications of tests, and viewing the broader picture of how we can cut costs across the board.
Pre-certification is NOT the same as guidelines – let’s work on improving patient care and cutting our costs in ways that make a material impact across the healthcare budget. As physicians, we want that above all else for our patients. As a patient, I expect most people want their doctors to request the right test at the right time, and to give appropriate and timely care – not to spend their days on the phone/fax to a third party trying to get approval for what they know their patients need.
So why not put into place guidelines? Why put a layer of bureaucracy in the system in the form of precertification? What if there is a delay in treatment because of the precertification and someone dies? Who is paying for this? What evidence is there that precertification will reduce health care costs? Precertification exists in the USA and it hasn’t helped costs there, it just adds complexity and takes the individual even further away from the care that they need. It’s not just the individual and their doctor, it’s some random third party working off of some “international guidelines.” Why have someone else come between me and my doctor? This looks like it will cause lots of harm!
There is nothing wrong with a fair profit……People do not become doctor to not get paid…..BUT the GREED has totally taken over and some doctors have totally sold their souls. There are doctors here I KNOW who are aghast at what went on at KEMH I hope there is a good amount of soul searching today by the local doctors
I will post this AGAIN:
I aint paying a bill that is a RIP OFF>….. 1000% over the cost of a blood test in the USA is unacceptable……..Take me to jail….but I am not getting ripped off by the hospital via my doctor……no way….. PLUS PLUS……they never tell you the costs when you question it they say “Oh you have Insurance DON’T YOU” – That ladies and gentlemen is the problem……UNTIL we have consumer protection and a price WATCH DOG to protect the Patient and the Insurer, the boys in the middle are playing BIG GAMES……
Why does every doctor and his mother these days have a lab ? Because there is BIG BUCKS in this labs, and big dollars in imaging – especially when the insurers pay out….and then are premiums keep going up and up and up…..
Then if the lab can’t do it they outsource the test (without telling you ) to the local hospital (or overseas) and then they mark that up a GAZILLION PERCENT % ……
As I say something needs to be done. If an MRI machine costs $ 1,000,000 and the locals are charged as much as $ 8000 then after 125 patients the machine is paid off…. That is a very QUICK repayment. Some MRI machines cost more. THAT said……If 300 MRI tests were done a year, and we say a TWO year repayment window was reasonable then the cost of the MRI should be $ 1,666.00 So round it up to $ 2000 to allow for the staff / operators etc This seems more like the right price.
http://www.kaiserhealthnews.org/stories/2012/december/09/mri-cost-price-comparison-health-insurance.aspx