Health City clashes with BritCay over coverage restrictions

Health City Cayman Islands has criticized a BritCay announcement that vastly limits coverage at the East End hospital.

BritCay sent a notice to its clients on March 29 informing them that effective April 1 the company would only authorize and reimburse cardiac-related procedures at Health City.

The hospital’s CEO Dr. Chandy Abraham said the decision was made unilaterally by BritCay and without prior notice to the hospital. BritCay refuted Health City’s claim, saying the hospital was notified a week in advance.

“Our first concern with regard to the announcement by BritCay has been the health and safety of our patients,” Dr. Abraham said. “The policy decision by BritCay appears, in our opinion, to be driven by considerations other than patient welfare and could have a negative impact on patients with regard to convenience, ancillary expenses and the safety of their health.”

The hospital urged that negotiations with BritCay remain transparent. BritCay and Health City were expected to meet Tuesday to discuss coverage updates.

A BritCay spokesperson said the company informed Health City of the change in insurance coverage on March 24 and is working closely with the hospital on reviewing changes.

The insurance provider said it signed an agreement with Health City in 2014 for tertiary level cardiac services, but the hospital has since expanded its scope of services.

“As a result, we have to make sure that all the services provided at Health City are compliant with our contractual requirements,” a company spokesperson said.

The insurer will only cover non-cardiac procedures at Health City that were authorized before April 1.

A BritCay spokesperson said the decision came from parent company Colonial Group and was not intended to send more patients off island for care.

“If a BritCay patient is currently undergoing a previously authorized treatment, for example, but not limited to, chemotherapy, physiotherapy or surgical follow-up, the patients will be allowed to continue with that treatment at Health City,” the company spokesperson said.

“We also understand that there may be circumstances where the need for non-urgent local treatment outside of cardiac-related procedures may be required at Health City and those cases will be considered by BritCay as presented by the referring or attending physician for authorization to provide the care.”

BritCay reminded patients that it will continue to provide access to care at other Cayman Islands facilities and through its network of hospitals in the United States.

Health City said the announcement has raised questions among patients about the hospital’s quality of care.

“We would like to reiterate that Health City provides service of the highest standard to all of our patients. We are the only medical facility in the Cayman Islands that has third party verification of our quality in the form of our accreditation by the Joint Commission International,” Dr. Abraham said. “We are also fully compliant with every government-imposed regulation in the Cayman Islands, as evidenced by the Health Practice Commission accreditation of our services.”

Employers in the Cayman Islands expressed unease as details of the coverage changes came to light.

Paperman’s Coffeehouse manager Paul Storey  suggested that the company may drop the insurance provider.

Mr. Storey said in a message to BritCay: “If you are not offering full coverage to allow my employees and myself the opportunity to choose where we receive our medical care within 60 days, I will actively seek out another insurer. I am sure I am not alone in feeling this way.”

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7 COMMENTS

  1. In short response this is totally unfair towards Health City Hospital. If a person is contributing towards insurance they should be able to go to what ever hospital for medical care. I do hope the next government make some changes with CINICO and government employers and all other paying. I have been suggesting times and time again that government employees should contribute something towards their insurance from CINICO, and they should have full coverage anywhere on or off island. Why stifle people from obtaining good health. Government can easily have an attachment of earnings put to all salaries where by a decided amount is withdrawn to assist with Health Insurance. Health is more important than food clothes a house or a car. How can a person contribute towards insurance and not given the full benefit. No that suppose to change.

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  2. This sounds like Obama health care has come to Cayman Islands . Then again why are one Dr sponsoring so many election candidates ,, and he says that he cares for the people and the Islands is why he is doing it .

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  3. I assume everyone realizes that the success of Health City in treating local patients is cutting into the bottom line of other local health care providers. This is not a criticism of the excellent job done by these other health care providers.

    It’s simply more competition.

    So one must wonder if these local health care providers have a hand in this decision.

    It would seem to be vastly more expensive for BritCay to send patients to the USA for treatment than to have it done here.

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    • You are absolutely right. Take health screening conducted by health authority this week. For the screening to have any benefits they forgot to mention that blood sugar and cholesterol tests must be done after 8-10 hours of fasting. For a blood sugar test to have any significance a second one should be taken 2 hours after a meal. For a cholesterol test to have any significance ldl hdl trigs and total cholesterol must be measured. People conducting so called screening must know that. The way they do it year after year is absolutely useless. DIY BP checking machines at supermarkets are free.
      So speaking of the quality of screening, they fail.

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  4. Well, it’s only right that a responsible insurer should properly assess the quality of care of its providers. That should apply where they get approved for one thing but then the scope creeps into other things. However, that creep also happens across all providers in Cayman and so it seems a touch strange that Health City are singled out. Also, the saving argument is complex because per patient something might be cheaper done on island but that only holds up if you don;t then end up paying more with your off-island provider network because they get less ‘business’. That’s just saying it isn’t a straight forward debate!
    Dr Sara Watkin
    Paediatrician, Grand Cayman

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