BHeC: $11,188 Health Expenditure Per Capita

October 7, 2015

[Updated] The Bermuda Health Council [BHeC] announced the release of the National Health Accounts Report 2015, which they said is “essential for monitoring Bermuda’s health system financing and expenditure trends.”

“The current report shows a marginal year on year decrease in the total expenditure in healthcare,” BHeC said. “The Report details health system costs for the fiscal year ending 31st March 2014 [FYE 2014] and explains changes since 2007. Data going back to 2004 is available in previous reports and Excel tables posted on our web site.

“The current state of positive collaboration between stakeholders has been one of the biggest investments for creating a better health system at better costs. For the next fiscal year, this collaboration will focus efforts on how we can better assist individuals with chronic conditions, those requiring post-acute and long term care, and developing local infrastructure so that our quality ranks high when compared to other jurisdictions.

Some of the additional key financial findings from the 2015 report are:

Total Health Costs in FYE 2014 [Table A.4 [Annex] of the report]

  • Bermuda’s total health spending was $693.1 million
  • This amounted to 12.4% of GDP
  • Health expenditure per capita was $11,188
  • This represents a decrease of 1.7% from FYE 2013, when total health expenditure was $705.0 million, representing 12.7% of GDP; and per capita health expenditure was $11,297

Funding sources: Where did the money come from? [Table 2.0.1 of the report]

  • 70% of financing was from the private sector [$485.7 million]
  • 29% of financing was from the public sector [$207.4 million]
  • Health insurance accounted for 60% of financing sources [$414.6 million]
  • Individual out-of-pocket payments represented 10% of funding [$66.4 million]
  • Donations to non-profit organizations contributed <1% of health financing [$4.7 million]

Expenditure: How was the money spent? [Table 2.0.1 of the report]

  • 51% of health spending was in the private sector [$352.7 million]
  • 49% of health spending was by the public sector [$340.5 million]
  • The Bermuda Hospitals Board accounted for 43% of total health expenditure [$299.7 million]
  • Overseas Care accounted for 14% of total health expenditure [$96.3 million]
  • Private, local health providers accounted for 21% of total health expenditure [$146.7 million]
  • Prescription drugs represented 6% of total health spending [$42.7 million
  • Health Insurance Administration accounted for 10% of total health expenditure [$67 million]

Trends and context

  • The most significant areas of growth in health spending were “other health providers, services, and appliances” [increased by 14.3%] and health insurance administration [increased by 8.5%]
  • The proportion of health spending on local physicians declined by 13.3%
  • Health spending as a percentage of Bermuda’s GDP decreased from12.7% in FYE 2013 to 12.4% in FYE 2014
  • The average expenditure as a share of GDP in countries of the Organization for Economic Co-operation and Development [OECD] was 8.9%
  • Life expectancy in Bermuda is lower than in many OECD countries; countries such as Canada, United Kingdom, and Portugal have higher life expectancy despite spending less per capita than Bermuda

Mrs. Tawanna Wedderburn, Acting Chief Executive Officer of the Bermuda Health Council, commented: “The Health Council is grateful for the public’s growing trust in Bermuda’s healthcare system. Efforts to earn this trust are reflected in the latest National Health Accounts Report showing Bermuda’s overseas care expenditures decreasing by $5 million from last year.

“Domestic and overseas trends usually show that achieving healthcare cost containment is challenging. To achieve cost reduction is remarkable. This achievement also reflects the significant effort being made by health professionals, providers, and insurers as we collaborate with them to introduce improvements that can enhance patient care. Going forward, the Health Council remains committed to continuing along the path of achieving affordable quality healthcare for all Bermuda residents.”

Dr. Ricky Brathwaite, Health Economist of the Bermuda Health Council, commented: “The data contained in this report, and the stories the Council hears from the public on a daily basis, indicate that we as a population are extending our resources to utilize a health system that continues to evolve in regards to its effectiveness and efficiency.

“Lessons from FYE 2014 should include the concept that although we have seen decreases in the size of our healthcare spend; the goal of system sustainability will actually require aggregate investments in system modernisation and individual change. Only with investment in improving processes, technologies, and information will we be able to achieve long term savings, improvements in quality, and most importantly a healthier public. ”

The 2015 National Health Accounts Report can be found on their website at under “BHeC Reports & Publications”; or you may contact BHeC for a copy at or 292-6420.

National Health Accounts 2015 in Brief follow below [PDF here]:

Update 11.08am: The Ministry of Health, Seniors and Environment says they “welcome the release” of the report, noting that it is “vital to understand trends in health spending.”

A government spokesperson said, “The Ministry of Health, Seniors and Environment welcomes the release of the Bermuda Health Council’s 2015 National Health Accounts Report, a publication vital to understand trends in health spending as they highlight factors influencing costs and steps needed to control expenditure.

“The finding that costs declined slightly from the previous year provides encouragement that some of the control measures implemented are having a positive impact. Nevertheless, there is still more work to be done and the Ministry is working with the Health Council, the Bermuda Hospitals Board and with private and public insurers and providers to continue to find ways to control health costs.

“In 2015, the Standard Health Benefit [SHB] premium was adjusted to modernize the basic benefits package and improve the health of some of the most vulnerable. The goal is to create better access to quality care by ensuring people can get ‘the right care, in the right setting, at the right time.’

“Evidence from health systems of other advanced economies has shown that quality, timely care is the most cost effective healthcare and focusing on quality will lead to a more affordable health system.

This year, several programmes were introduced under the Standard Health Benefit premium that should yield further reductions in health expenditure in future years, namely:

  • An enhanced care pilot to better manage select chronic non-communicable diseases in uninsured and underinsured patients, as a result decreasing the probability of preventable, costly visits to the hospital.
  • Diversification of Health Insurance Department programmes for HIP and FutureCare that will allow more critical benefits that improve health and reduce costs [e.g. home health care, smoking cessation].
  • Progression of a modernization plan of services at the hospital.

The Minister of Health, Seniors and Environment, the Hon. Jeanne Atherden said “The green shoots demonstrated in the 2015 National Health Accounts indicate that measures to control utilization and right-size our health system may be yielding positive results.

“We continue to work hard to identify every possible measure that will control health costs for individuals, families and employers, and we are grateful for the collaboration of private and public healthcare providers, insurers and the public to realize this.”

“The Minister said much work remains to be done, but the measures taken in 2015 should put the health system in good stead to see further cost control in upcoming years that can translate to a positive impact on premiums in the medium term.”

“For now, I believe we are on a better track and many stakeholders are working hard to control costs. We continue to encourage the public to do their part by practicing healthy lifestyles, eating a balanced diet, doing regular physical activity, avoiding smoking, etc., as these simple steps help to keep health costs down for everyone.

“Unhealthy populations create greater costs for the economy, so it’s more important than ever that Bermuda become as healthy as possible.”

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  1. Build a Better Bermuda says:

    This needs to be done better, we should not have to wait 18 months for a health care spending analysis. I understand that there is a 1 year clearance for filing claims, however, the vast majority of claims are filed promptly and analysis of year over year review should provide a window amount for any missing data on late claims, with that there is no reason why we have to wait until September/October the next year for 18 month old data… 6 months should be the outside. We should be be getting 2015′s report, not 2014′s report labelled as ‘this year’s’ health care spending. This practice is old and needs to be changed. In fact they should be collecting data on a monthly or quarterly basis, so that we can better manage the cost of health care, 18 month old data is practically useless. Time for the BHeC to step up, the vast majority of companies that would be involved in providing the healthcare costs numbers probably already have monthly or quarterly reports for their own purposes.