PCTI

NHI Bahamas officially started its journey in 2017 to transform the healthcare system, upon which the future well-being of Bahamians depends. This transformation aims to provide access to affordable, quality healthcare. With high patient satisfaction rates and an increasing number of people who are covered under NHI, NHIA and the government have established a strong foundation towards the ultimate objective of Universal Health Care or the people of The Bahamas.

The PCTI will bring together the public and private Primary Care delivery networks under a common and comprehensive model of care that improves quality, consistency of experience, and is accessible without any cost at the point of service. It aims to integrate the public Primary Care system, implement pragmatic reforms to private insurance, and provide every eligible person with a single Electronic Health Record.

Duplication within the public healthcare system means the NHI program and existing public clinics are operating in parallel. Expansion to high cost care would become prohibitively costly without the integration of these two parallel systems. Recent events like Hurricane Dorian and COVID-19 have exposed the weaknesses of a fragmented health system that needs more coordination and protection for those that need it most. All of these issues lead to a lack of continuity of care and created the need for an integrated Primary Care system.

The Standard Health Benefit (SHB) will be available for anyone who enrolls with NHI without having to pay any premiums nor additional copayments or deductibles. The SHB covers Primary Care through preventative medicine and diagnostics for early risk identification and coverage for specified life-saving treatments. The Electronic Health Record (EHR) will safely secure patient Primary Care information without relying on physical infrastructure. A patient-centric Primary Care model using the capitation payment model which allows for greater accountability and reliability.

NHI’s delivery framework is designed around the patient-physician relationship and can be enabled digitally by the EHR.

Telehealth alleviates geographic or mobility concerns and moves our healthcare system into the modern era. A patient portal enhances the patient experience with features such as allowing Bahamians to book appointments online rather than line up early in the morning. The introduction of each of these elements with enhance the patient-physician relationship.

Private insurers will be required to mirror the Standard Health Benefit (SHB) for their policyholders. The PCTI is the first step to protect those who have pre-existing conditions from being unable to qualify or obtain an insurance policy to access SHB coverage. The PCTI will ensure access by supporting existing public clinics that serve remote populations continue to exist, providing digital access and promoting private sector investment and fiscal certainty through use of the capitation payment model. This model will also encourage accountability and quality among healthcare.

The current fragmented structure is leading to inefficiency and high costs; as well as infrastructure that requires upgrading and maintenance. By addressing these two key challenges, The Primary Care Transformative Initiative will save taxpayers an estimated total of B$55M by 2025. PPPs will inspire innovative solutions in the healthcare system and help solve some of the bottlenecks being faced in the public sector. More productive workers and Gross Domestic Product growth due to lower mortality and less morbidity as well as reduction in unemployment due to illness. Increased community cohesion and positive emotional and social development for future generations.