Gov’t taking steps to change BVIHSA fee structure
Premier Dr Natalio Wheatley has indicated that the government is moving to change the fee structure at the BVI Health Services Authority (BVIHSA) to improve its financial health and service delivery.
Speaking on the Talking Points radio programme, Dr Wheatley said the current global subvention payment model is not sustainable.
“As the national health insurance is currently constructed, the Health Services Authority doesn’t benefit as much as they should,” Dr Wheatley stated. “Right now, they receive… a global subvention. Meaning, no matter how many services they deliver, they get this one payment.”
Under the existing system, BVIHSA receives a fixed annual payment of $42 million regardless of the number of services provided. “It’s not the best way to do it. The better way is every time you deliver a particular service, you have a charge,” Dr Wheatley explained.
He noted that the current arrangement disadvantages the public hospital compared to private healthcare providers. “The private sector wouldn’t accept that. Every time they deliver a service, they would want to know that national health insurance is making a contribution towards that service. And it’s obviously been very successful for the private sector,” he said.
The Premier said the government has already taken steps to address the issue, including reconstituting the contract committee to recommend adjustments to the fee structure.
“The intent is to be able to have that contract committee in place to be able to change the fee structure so that hospital and the health services would be able to benefit more from the national health insurance,” he stated.
Premier Wheatley also zeroed in on concerns over government funds being used for private healthcare when public services are available. “We must consider whether it’s the best use of government’s money to have those persons go to private healthcare providers,” he stated.
In addition to the fee structure change, the government previously announced plans to engage a financial expert to assist the BVIHSA with its fiscal challenges. Health Minister Vincent Wheatley warned that expenses could escalate without effective financial management, stating, “It’ll be $20 million this year but $40 million next year.”
The Premier also revealed that the government has decided to write off nearly $20 million owed by the BVIHSA, primarily in unpaid taxes. He said this measure would strengthen the Authority’s financial position.
Copyright 2025 BVI News, Media Expressions Limited. All Rights Reserved. This material may not be published, broadcast, rewritten or distributed.
Thank you sir for having the courage to look at the systemic failure of NHI payment (not NHI itself) and changing it instead of kicking the can down the road or even easier blaming the Minister.. There will be alot of people coming after you because you are messing with millions of dollars out of their pockets. It is also noted that the so called VG committe to improve health ccare in the BVI could not come up with this why? Because you are taking on a powerful sector and their real motive had nothing to do with improving healthcare. That sector will not take this sitting down so prepare for a fight.What you do have is the public to back you up when they have the facts. Hopefully they will be smart enough to see through the BS that the private sector will spew. Their attack will start with critizing your health Minister as inept. The persons who wrote and structured the payment system this way also have their obstructionist puppet in a key position to at BVIHSA to stop all reforms that will impede their flow of money so watch him. You sir will have to be smart enough to stand firm . They public will have to be astute enough to see through the nonsense.
To get set prices/fees to be charged by Private Health care providers to NHI, instead of constantly overcharging NHI and making ridiculous profits. Just look at all the construction in the private sector. The individual person is not prepared to go to the hospital knowing that not even the most basic supplies are available and you might end up dying just for choosing to go there.
Dr. Wheatley be careful what you are saying Hospital is now getting 42 million per year from NHI but the limited services it is offering if claims are submitted it might be less. At the moment, please concentrate on offering more and better service, then you can make such a move.
Changing the system without FIXING THE SYSTEM makes no sense. The reason most people go to the private health establishments is because they will get quicker and more reliable service. If you go to the public hospital/clinic it’s an all day affair and you still feel like you need a 2nd opinion. The Government needs to do a proper overhaul of the hospital, INVEST in getting it where it needs to be, THENNNNNNN make the changes to NHI to ensure that most people utilize the public areas before turning to private. All that needs to be done is 10% copay at the Government facility and 20% copay at private, problem solved but only if the government upgrade their facilities to match demand/service.