Puerto Rico aiming to achieve new health system by 2019

The government of Puerto Rico plans to remodel their health system. They hope to achieve a more efficient system and reduce their spending by 2019.

The proposed health model is patient oriented providing with improved access and not limiting by region. The model also identifies immediate measures to reduce administrative expenses and fraud detection.

The decision to remodel was announced at the Puerto Rico Health & Insurance Conference 2017 of the Chamber of Commerce of Puerto Rico. The health reform proposed includes turning Puerto Rico into a single region, creating competition and cost-effectiveness and improved patient access. There will an increase in the number of insurers and medical groups.

The Government will pay for basic and less expensive options. Through this model, the government plans to achieve savings of USD900 million over ten years. Uniform payment plans for suppliers and ancillary services would be established. Reimbursements would be limited to an average of 70% of Medicare’s scheduled payment for fiscal year 2015.

The government will also implement cost-saving strategies to control drug spending, enforcing compulsory dispensing of generic drugs These initiatives are anticipated to generate USD500 million in savings over the next decade. Likewise, services that could be limited and / or eliminated from the current benefits package would be evaluated, such as dental cleaning limited to twice a year. This change in services is expected to reduce costs by USD400 million over the next ten years.

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