The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

A senior Doctors Hospital executive says it has moved to combat "access and affordability barriers" to healthcare stemming from COVID-19 job losses and increasingly stringent insurance policies.

Dennis Deveaux, the BISX-listed healthcare provider's chief financial officer, told the Andros Business Outlook conference that onerous "out-of-pocket" and deductible terms were effectively making health insurance policies "non-viable" as a means of giving Bahamians access to quality private healthcare.

He cited, as an example, one medical insurance policy that set a "room rate cap" of $375 per day regardless of the severity of the patient's illness. When compared to the $5,000 per day room rate charged by South Florida's Cleveland Clinic for an intensive care unit (ICU) bed, Mr Deveaux argued that this was "not insurance at all".

With thousands of Bahamians also having lost, or in danger of losing, their employer-sponsored group health insurance due to the wave of business closures, temporary lay-offs and permanent terminations associated with COVID-19, he added that Doctors Hospital had introduced its Loyalty Advanced Membership Programme (LAMP) to ensure persons could still access its facilities for care.

Detailing the various elements involved in LAMP, Mr Deveaux said that for $40 per month persons could access unlimited primary care from a Doctors Hospital physician plus obtain two free scans/images in any given year.

And, for $20 per month, the BISX-listed healthcare provider will "waive" all out-of-pocket fees and deductibles associated with any "out-patient" services it provides on the basis that "money cannot be a pre-condition" determining whether Bahamians get access to healthcare.

Mr Deveaux acknowledged that Doctors Hospital is now "confronting the economic reality" faced by all global healthcare providers due to the COVID-19 pandemic, "which is access and affordability" to healthcare for thousands of persons and their dependents.

"As people lose their jobs, which is something that is happening all around us, it's clear that because insurance is most commonly tied to your place of employment, people are ultimately going to lose their insurance," he added. "That reduces access to private quality healthcare.

"But even for those fortunate to keep their employment, we've recognised there's an increasing trend of what we refer to as consumer-driven plans. Consumer-driven plans are where the out-of-pocket obligations for the person who walks in with the insurance card, those obligations are so significant that it almost renders the product itself non-viable financially.

"This is your co-payment or deductible that may he as high as 40 percent. I saw a plan just yesterday that had a room rate cap of $375 a day regardless of the acuity of the patient. So, to put that into perspective, if you go to the Cleveland Clinic in South Florida, the daily room rate for ICU (intensive care) level would be in excess of $5,000 a day," Mr Deveaux continued.

"So the insurance plan that has a $375 per day room rate is not insurance at all. We strategised and talked about what we could do to lower the barriers to access and make it more affordable to access Doctors Hospital."

This, Mr Deveaux explained, prompted LAMP's introduction. For $40 per month, its pre-paid plan component gives patients as much access to a Doctors Hospital primary care physician as they need without any limits.

Besides the two free imaging scans per year, the Doctors Hospital executive added that the plan also gives a female member and their mother the chance to have one mammography per year to combat breast cancer.

"We have provided along with that a host of other discounts to make the service line more affordable," Mr Deveaux said. "The reaction has been phenomenal. It's something we're looking to deploy beyond Nassau...

"The price of access is only really good if people can afford it. We think at $40 per month that's the right price point that allows people access to private, world-class healthcare."

Turning to LAMP's second element, Mr Deveaux said this featured a $20 per month "insurance supplement" that provides "a complete waiver of whatever out-of-pocket obligations exist".

He added: "So those co-payments and deductibles that frequently exist for out patient services, we took a decision at the hospital to effectively waive those requirements.

"One of the questions I frequently get asked is: What's the catch? I answer: 'There's no catch'. We are willing as a company, in order to lower the barriers to access, to waive deductibles and co-payments for any out-patient services delivered by Doctor's Hospital: Full stop.

"We think this is a core part of responding to the new reality that those folks who have lost their jobs, and those who have kept theirs, simply do not have the financial resources to access healthcare like they traditionally do."

Mr Deveaux said COVID-19, and the associated safety protocols that had to be adopted, dropped Doctors Hospital's bed occupancy rate from an average of 40 persons per day to just 22 at the 72-bed facility.

Elective procedures and out-patient services were cancelled, resulting in Doctors Hospital seeing "most of its revenues cut in half in 45 days". Mr Deveaux said the healthcare provider guaranteed its then-535 full-tine staff their full salaries, and 40 hours of work, for the first three months of the pandemic although he made no mention of the subsequent 43 terminations.

Expenses in non-clinical areas were cut by 48 percent in two months, he added, with senior executives and management taking voluntary pay cuts of up to 25 percent and ten percent, respectively. "We shored up the balance sheet. We made sure the hospital as much financial strength and cash as we could physically put our hands on," Mr Deveaux said.

He added that Doctors Hospital also increased the discounts offered to health insurers to aid the latter's cash flow, while a COVID-19 drive-through testing facility has been set up at its Blake Road facility that is currently testing between 75 to 100 patients per day.