Omar Anderson, Staff ReporterTHE MINISTRY of Health is opposing a system that Blue Cross of Jamaica intends to implement to encourage efficiency among healthcare providers. The Government is concerned that the move may lead to increases in drug and healthcare costs.
Blue Cross, along with Advanced Integrated Systems Limited (AIS), wants to introduce an American computer software expected to cost healthcare providers (pharmacists, doctors, laboratories, dentists, etc.) a total of US$900 ($37,800) each, plus a further 1.75 per cent of the cost of each claim that is made to Blue Cross.
Grace Allen-Young, acting permanent secretary in the MoH, told The Sunday Gleaner last week that the Ministry will not be supporting the proposal, because its implementation could fuel an increase in the price of drugs and healthcare and also threaten the survival of the Jamaica Drug for the Elderly Programme (JADEP).
"We (the Ministry) are not in a position to even consider any system that will add any cost to healthcare providers and prove a burden to consumers," Mrs. Allen-Young said.
Mrs. Allen-Young said that most of the 120 pharmacists who participate in JADEP accept Blue Cross insurance cards. JADEP was introduced in 1996 to provide drugs at a reduced price to elderly persons who suffer from chronic diseases like arthritis, diabetes, glaucoma, hypertension and asthma. The seniors pay $25 for one or two drugs; $50 for three or four drugs; and $75 for five or six drugs - prices which Mrs. Allen-Young considers minuscule.
Mrs. Allen-Young said pharmacists have acted in good faith in participating in JADEP and the Ministry does not want to disrupt the programme.
"We could not consider imposing something that would be a cost to them (pharmacists)," she said.
However, Victor Anderson, Blue Cross's vice-president of information technology, said last week that he does not think pharmacists and medical practitioners should charge consumers more while using the new system. He said under the system Blue Cross will pay healthcare providers at least two weeks earlier, and fraud existing in the current system would be eliminated in the new system.
"The procedure will improve the speed at which they (healthcare providers) get their claims settled and they won't have any bounced claims because as soon as somebody comes into their office, they will be able to confirm whether the member is eligible for service," Mr. Anderson said.
Blue Cross does not charge to process claims under the current system. Mr. Anderson claimed this process can take up to two months, starting from the point healthcare is delivered to the time the providers are paid.
He said the new system, however, should not create any increase in the cost of drugs and healthcare.
"I don't see why an increase is necessary," he said. "I'm sure people might be tempted to do it but when they think about what their money is worth to them to have it earlier, I think people will see it's worth the 1.75 per cent."
In explaining how the systems works, AIS's Chief Executive Officer, Douglas Halsall, said the programme will process a claim immediately, send an electronic signal to the healthcare provider along with a configuration number, and within a week Blue Cross will pay the healthcare provider.
Vivienne Watson, president of the Pharmaceutical Society of Jamaica, said her organisation welcomed Blue Cross's new system.
"We have a problem with claims that aren't good, so this is going to make life a lot easier," she told The Sunday Gleaner.
Mrs. Watson, however, said the Society does not think its members should pay the 1.75 per cent charge.
