Our work in action

Our work in action

Read about some of our recent engagements.

Read about some of our recent engagements.

Approximately a third of Bahamians have private insurance that provides access to quality but costly care. The remaining two thirds rely on a public system where patients routinely face long waits and unreliable and differing levels of care. Furthermore, health services, whether private or public, are not well integrated or coordinated and many opportunities for improved system performance remain. Combined with a high and increasing burden of disease and rising costs in both the public and private systems, the need for transformation to a health system that is more modern, accessible and affordable is indisputable.

Several previous attempts at introducing a unified National Health Insurance (NHI) system, dating as far back as the early 1980’s, have been obstructed by political turbulence, vested interests in the status quo and implementation challenges. However, this cycle is being finally broken. After a renewed push by government, with support from KPMG in the Bahamas and KPMG’s Centre for Universal Health Coverage, the Bahamas is in the midst of implementing ‘NHI Bahamas’ – the most significant national development program in over a generation. 

NHI Bahamas represents a wholesale transformation of the country’s health system. In the initial phase to be rolled out in May 2017, primary care physician services will be provided free at point of care at approved providers across the public and private systems, as well as many drugs and diagnostics. 

KPMG’s multi-disciplinary, multi-national team has been working since February 2016 to support NHI Bahamas in the following areas:

  • Drafting UHC and NHI guiding policies;
  • Defining and costing the initial NHI benefits package;
  • Negotiating new physician fee schedules with options for capitated, bundled or fee-for-service models;
  • Establishing an integrated governance structure to direct the implementation of NHI and health system strengthening efforts;
  • Procuring a private operator to run the new public insurer (BahamaCare);
  • Designing the IT architecture to support the scheme and supporting the procurement of the IT solution;
  • Developing relevant legislation and regulations;
  • Providing health system strengthening support to bring public primary care clinics up to the required standards;
  • Facilitating stakeholder consultations with key constituencies throughout the process.

From the start, the work has been designed to not just introduce primary care coverage but to build this as the foundation for further NHI phases that will cover hospital and other care needs, thus progressively achieving a sustainable and efficient model of universal health coverage. 

NHI aims to positively impact the lives of all Bahamians - increasing access to quality care, controlling rising cost and improving population health. NHI Bahamas has now also been shown to be an investment in the national economy, with KPMG analysis showing that over a generation the scheme will produce around eight times its costs in additional GDP: a comprehensive investment in the health and wealth of the nation. 

 

About KPMG’s Center for Universal Health Coverage (UHC)

KPMG’s Center for UHC is the hub for a growing portfolio of global projects helping countries achieve ‘health for all’. Leveraging the knowledge and experience of our 4,500 health professionals across 50 countries, our Center for UHC makes this expertise available to member firm clients that wish to make real progress towards universal health coverage.

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