Cabinet: No health insurance fee increase this year

Most doctors ignore gov’t request for financial information

Kincily Cletus, radiographer, demonstrates Cayman Islands Hospital’s new X-ray machine.

Cabinet announced Thursday that it would not increase the minimum fees that health insurance companies pay for procedures after fewer than 10 doctors responded to government requests for financial information.

“We commend those healthcare providers who did respond to the survey but unfortunately it was not sufficient.”

A consultant’s report on healthcare costs, completed last year but released this week, recommended the fees paid by insurance companies be increased by 12.3 percent to adjust the rate schedule.

Consulting company Morneau Shepell recommended reviewing the standard health insurance fees schedule annually.

The consultants asked 139 physicians and 67 health practices to voluntarily provide financial information so Morneau Shepell could study how much medical procedures cost in Cayman. Only 40 responded, according to the consultants, and fewer than 10 provided the financial information.

“This made it extremely difficult for the consultants to have a high degree of confidence in determining a reasonable level of cost of operating the medical practices,” Ministerial Councilor for Health Roy McTaggart said in a press release.

“As a result, it was very difficult to establish a fair level of fees for services provided by the healthcare provider. We commend those healthcare providers who did respond to the survey but unfortunately it was not sufficient,” he added.

The standard health insurance fees have not changed since they were created in 2005.

The Health Services Authority and the Cayman Islands Medical and Dental Society have their own fee schedules. The health insurance fee schedule is set as a minimum for employer-provided health insurance coverage.

The doctors who did respond to the voluntary survey said operating costs in the Cayman Islands are higher than in other jurisdictions due to immigration and staffing costs, the price of malpractice insurance and the small size of the market on the islands.

The consultants wrote, “Some physicians felt that fees paid by the insurance companies are not adequate to sustain the viability of a medical practice. Most physicians [who responded to the survey] felt that the SHIF [standard health insurance fees] should be adjusted.”

The statement from government notes that Cabinet members are willing to review the fees again next year, but hope for more participation from the healthcare industry.

Jennifer Ahearn, chief officer for the Health Ministry, said in the statement, “We need the healthcare providers’ cooperation to do this, as we can only determine a fair level for the fees based on the information they provide us with.”

She added that the doctors’ information on pricing was confidential.

Any changes in the fee schedule would likely increase health insurance premiums, the consultant’s report states. Rate changes could also increase administrative costs for doctors.

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