With today being the deadline for first-round sign-ups of primary care physicians under National Health Insurance (NHI), Guardian Business has gotten a first look at the possible capitation schedule for outpatient services.
In a document received by Guardian Business labeled "confidential draft", it is revealed that capitation for providers could range from $24 per patient at the low end for "telephone services" and $78 on the high end for a "complex visit". In the middle range are an "intermediate visit" at $60 and a "periodic health assessment" for new patients at $66.
According to the document, capitation for primary care physicians is dependent on certain risk adjusters, outlined as "age, gender and geography".
The fee schedule for physicians is much more involved than simply the aforementioned rates, and are dependent on a number of factors outlined in the NHI document. However, some physicians have not been happy with the initial fee schedule presented to them and are still not up to speed on capitation.
Recently, Medical Association of The Bahamas (MAB) President Dr. Sy Pierre pointed out that NHI officials had not "made clear" the terms of remuneration for physicians.
Pierre guessed that the remuneration fee per visit could range from $30 to $70.
But he lamented that, depending on the final price, the set remuneration schedule might not be sufficient for physicians to cover fixed costs, malpractice insurers and staff wages.
"You can't run a practice on that," he said.
"Everyone has an idea that the remuneration is not going to be the same obviously as a commercial insurer, so it's going to be a lot less."
The NHI Secretariat had informed all primary care providers in a statement that the closing date for the first round of NHI Bahamas-registered providers is March 31, 2017.
"Registration for primary care physicians is a critical milestone as we prepare to enter phase two of NHI Bahamas enrolment," the secretariat said.
Pierre explained to Guardian Business that at the beginning of the registration period, once enrolment begins, Bahamians will be selecting their doctor from the public or private sector.
This part of the NHI rollout focuses on primary care physicians. Doctors who work in the hospitals are still anxious about what the NHI rollout will mean for them.

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