Transforming Healthcare in the Caribbean | KPMG | CA

Transforming Healthcare in the Caribbean

Transforming Healthcare in the Caribbean

We deliver the results that matter.


National Leader, Management Consulting

KPMG in Canada


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The Commonwealth of The Bahamas set a milestone in spring 2017 with the launch of the nation's National Health Insurance (NHI) program, the first and most critical step towards Universal Health Coverage (UHC).

NHI is one of the largest social developments in Bahamian history, and it was a long time coming. After decades of political and public debate, the government made the decision to set the foundation for UHC and move forward on a nation-wide primary healthcare program before the initiative could be delayed any longer. To that end, it engaged KPMG in The Bahamas, who partnered with KPMG in Canada and with the support of the KPMG Global Healthcare Centre of Excellence, to define the vision for NHI and lay the foundation for a system that would deliver high-quality primary healthcare services at no personal cost to over 390,000 Bahamians.

"Think of developing the Ontario Health Insurance Plan (OHIP) from scratch," says Shripal Doshi, Senior Manager, Management Consulting, KPMG in Canada. "Setting up the entire organization required to run the program was part of the work that needed to be done."

Over the span of 15 months, every detail of the proposed national healthcare plan was assessed, analyzed, and planned. From NHI's proposed financing, legal, and policy considerations to issues of governance, organizational design, and technological requirements – nothing was left to assumption. Out of this critical phase came a definition of the benefits that would be covered and a game plan for the program's initial rollout, beginning with primary care physician services followed by prioritized laboratory testing, pharmacy, and diagnostic imaging services.

Defining those benefits meant establishing fair and sustainable reimbursement fees for healthcare providers. That also meant supporting the Government in negotiating those fees with providers and implementing a broad stakeholder management strategy that included engagements with the insurance sector, business community, faith based groups, and other stakeholders to ensure the model met their needs.

The Bahamas' move to commence on the path towards UHC wasn't just ambitious, it was unprecedented. Nearly two-thirds of the population lacked basic health insurance before the establishment of NHI, and prior to this monumental push, it seemed as if the vision would take years more to become a reality. On May 14, 2017, retired school teacher Betty May North from Nassau, Bahamas, became the first person to be treated at no personal cost through the NHI system; and by the end of its first month, 18,000 Bahamians were enrolled in the program, representing five percent of the population, and the number continues to grow, now at close to 30,000.

With over 100 participating doctors in both the public and private sector now involved with the program, the future of NHI Bahamas looks bright. And, with plans to expand the program into secondary and tertiary care services, Bahamian leaders are on track to meeting their larger goals of making their population the healthiest in the Caribbean by 2040.

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