Island Health Services hopes to resolve copayments issue

by Curlan Campbell, NOW Grenada

  • 90% of medical supply comes from United States and requires upfront payment
  • Currently, Ministry of Health and the Grenada National Patient Kidney Foundation pay just under 20% of cost
  • Government patients’ debts in excess of EC$300,000

Dialysis patients on Monday were hit with the news that the co-payment arrangement for dialysis treatment can no longer continue. The notice issued by the Island Health Services (IHS) to dialysis patients stated that the decision taken was unavoidable since the institution, as of 4 May 2020, is yet to receive financial contributions from the Ministry of Health for the month of March and April due to the Covid-19 pandemic. As a result, dialysis patients will have to fund their treatment from their pockets until the copayments can be resumed.

“We will now be placed in a dire position, where the copay arrangement will no longer apply and treatments will have to be paid in full, at the point of care, until the processes return. We are also still without 2 months of contributions from the Ministry of Health as well. Sagicor, the nation’s (region) leading health insurance provider has also informed us that they will not be paying out until the end of the current restrictions,” the notice stated.

The problem of providing dialysis patients treatment during the Covid-19 pandemic has been further compounded as 2 new patients have been added to the existing 16 patients already on treatment. An advisory from the Grenada National Patient Kidney Foundation indicated that the fees for 16 patients for March and April will be paid, but until further notice the foundation will be unable to fund patients fees due to financial constraints.

“Fast forwarding to April 2020, not only are we now without 3 months of contributions, but our patient population has just increased. Compounding this, 90% of our medical supply comes from the United States and requires upfront payment. Therefore, obviously, the cash flow situation could not continue for much longer, and we had to make an adjustment for the interim period in order to protect our medical supply chain and stay open for our patients. Unfortunately, this meant that the burden of the cost would temporarily fall solely on the patients until we got clarity and assurances from insurers, government and other contributors,” said Trevor Forrester, Managing Director of Island Health Services.

Forrester also took the opportunity to dispel rumours that patients will be cut off from treatment. “No patients were going to be cut off as has been reported. We had set a “cut-off date” by when this decision and changes had to be implemented by. I reiterate that no patients were going to be cut off from treatment, but rather the charges will be their responsibility. Once we have supply, care will always be provided,” Forrester said.

A letter to the Ministry of Health stated that the addition of 2 new patients will further reduce the supply reserve of the treatment centre.

Forrester spoke to NOW Grenada on the financial challenges faced by the treatment centre during this pandemic. “Hemodialysis is a cost and labour intensive medical operation, which has to operate daily even when we are not seeing patients. Under the current arrangement, Ministry of Health and the Grenada National Patient Kidney Foundation pay just under 20% of the cost and the patient pays her/his portion of medical costs (or co-pay) at the point of care. Most patients are unable to pay the remaining 80% and have accounts in arrears of EC$35,000.00 on average, so we work special terms with all patients on that amount to try to maintain their level of care. Therefore, even prior to the global operational disruptions caused by Covid-19, government patients’ debts were in excess of EC$300,000; this was even after a large break on long outstanding debts were awarded in December 2019,” he said.

Island Health Services is, therefore, requesting a meeting with officials from the Ministry of Health to discuss the way forward. “Since the notice was sent out, we have received good communication from all stakeholders, and have already made arrangements to rectify the issues.”

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