SMMC: Tariff increase long overdue, in pipeline since 2015

CAY HILL–St. Maarten Medical Center (SMMC) says the tariff increase which went into effect on January 1, has been in planning since 2015 and was already long overdue.

“This was well before the passing of Hurricanes Irma and Maria,” General Director Kees Klarenbeek and Medical Director Dr. Felix Holiday told The Daily Herald. “The previous rates were not increased as of 2004, while the costs did yearly increase substantially in the healthcare sector.”

According to the two officials, the costs to provide treatments and services were higher than the rates being charged. As a result of the lack in rate increase, the hospital was operating at a loss for the past several years. SMMC therefore “needed to increase” the rates and it is important that “all private insurers pay their fair share as well.”

The two said the increase is necessary at this juncture, because “we need to keep hospital care available and sustainable. For keeping hospital care available it is necessary to apply the rate increase. It is a fact that hospital care is a relatively expensive service, as a hospital facility should always be available to the public – also, in evening and night hours, public holidays and regardless of high season or low season. We need to ensure full availability to all required medical services always, for emergency cases. Thereby, globally the quality demands for hospital care are continuously increasing; to be able to meet these demands the costs are increasing too and that also reflects in the necessary rates.”

SMMC is also diligently working on the expansion of its services. Without the rate increase the hospital would not be able to expand its services. “Expansion of services will be of great benefit for the country and the population. At this moment we do not yet have all the basic medical specialties available in our country, which leads to enormous – and still increasing – expenses for medical referrals abroad. Think of all costs for flights, caretakers accompanying patients, hotel expenses and more expensive treatments abroad. Providing care locally will have a significant cost-saving effect on the medical referral expenses, and will reduce discomfort for our patients.”

The tariff increase “is supported” by the Ministry of Public Health, Social Development and Labour VSA. “Discussions have been held jointly with the Ministry as early as 2015 on the increasing need for a price adjustment,” the General and Medical Directors said.
Asked whether all health insurance companies have agreed to pay the increase, the two said: “Notice has been given with a fair amount of time for necessary adjustments to be made. The SMMC will try its best to ensure that insurance companies are in agreement with the terms before February 1, 2018.”

St. Maarten Insurers Association (SMIA) President Dwayne Elgin has not yet responded to questions posed by this newspaper for his position on the tariff increase.
The SMMC officials explained that while the increase is already in effect, insurance companies have been given an additional month to finalise things on their end as well as, for those that have not yet signed agreements with SMMC on the increase, to be able to do so. A number of insurance companies have already signed off on the increase.

The rate increase will enable SMMC to realise the goal of providing “safe, quality care” close to home. Within the last few years, SMMC’s services have grown considerably. It has, for example, expanded its Ear, Nose and Throat (ENT), Dermatology, Paediatric, Surgery, Cardiology, Internal Medicine and Dialysis services. A further increase in services – with Neurology, Orthopaedics and Ophthalmology – will provide the patient population with the possibility to remain on the island for treatment and reduce discomfort by travelling. For example with the recent introduction of Urology services, over the past five months hundreds of patients have received treatment close to home at SMMC, Klarenbeek and Holiday said. This provides a benefit not only for the patients, but also for the insurance companies by reduction of costs. “SMMC can, however, only maintain its current services and further expand the services with viable rates,” they said.

Sections of the community have expressed concern about the increase including the Consumer Coalition, which have since met with SMMC on the matter.

Source: The Daily Herald https://www.thedailyherald.sx/islands/72732-smmc-tariff-increase-long-overdue-in-pipeline-since-2015

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