IN the past few weeks we have explored alternative health-care financing mechanisms that could accommodate the large population of informal sector operators and others with fixed income in Jamaica in a bid to ensure health equity. Each of those options brings significant added value to the health-care ecosystem.

In today’s column we will explore subscription or membership-based models of care which are relatively easy to implement, user friendly, and affordable, and most importantly, allows for the extension of care to large segments of the population without intrusive third-party involvement or bureaucratic obstacles to access. These models of care have been growing rapidly over the past several years due to the increasing difficulties from traditional models of health-care financing.

The subscription model is advantageous for both the service provider and the patient. For health-care providers such as hospitals, it helps them to predict and manage the demand and supply more seamlessly. With the recurring fixed pricing model, patients can readily predict and manage their health-care expenses, while health-care facilities can predict revenue and so maintain their budget, accordingly. The financial structure of the subscription or membership-based models of care allow providers and hospitals to focus on quality-of-service delivery without the encumbrances of bureaucracy or third-party actors that may be more motivated by profit rather than quality. The subscription model also helps physicians and hospitals to broaden their loyal customer base along with fostering a long-term relationship with customers. The doctors can pay due attention and time to each patient. Instead of the number of patients served, they can focus on the quality of care provided, which will ensure a better health outcome for patients.

The subscription model is a highly customer-centric approach to health care and offers a lot of benefits to the subscriber or customer as compared to the service provider. From the free consultation to discounts on medicines and tests, to the minimal amount for accessing services, the subscription-based health-care model, from time to time, provides many exciting and attractive offers to the customer. Currently, patients are required to pay a varying amount of fee for each visit to the doctor, and sometimes the budget may get out of pocket. The subscription model ensures regular check-ups, routine monitoring, and easy diagnosis of a disease that gets often delayed due to financial constraints.

Subscription-based health-care services have the potential to improve access to care for citizens in Jamaica and other low-income countries in several ways:

1) Affordability. Subscription-based models often offer fixed, predictable monthly or annual fees for a specified or comprehensive range of health-care services. This predictable cost structure can make health care more affordable for individuals with low incomes. It eliminates the need for upfront payments or high out-of-pocket expenses, allowing individuals to access care without financial strain.

2) Primary or specialised care. Subscription-based health-care services typically offer either a primary care option that covers primary care visits, preventive care, and routine in-office diagnostics or speciality care that covers specialist consultations and specific diagnostic investigations and therapeutics within the speciality. This comprehensive approach ensures that individuals have ready access to direct primary or speciality care, promoting early detection, disease prevention, and continuity of care.

3) Enhanced access to care. Subscription-based models often prioritise access to care services by offering unlimited or frequent access to primary care physicians or specialists. This emphasis on access to care helps individuals manage chronic conditions, receive preventive care, and address their basic health-care needs. By focusing on access to care, these models can reduce the reliance on expensive hospital-based care and improve overall health outcomes.

4) Convenience and timely care. Subscription-based health-care services often provide convenient and timely access to care. They may offer extended office hours, same-day or next-day appointments, and telemedicine consultations. This accessibility can reduce waiting times, ensure timely interventions, and improve overall patient experience.

5) Health promotion and education. Subscription-based models often emphasize health promotion and education, empowering individuals to take proactive steps towards their health and well-being. These models may offer wellness programmes, health coaching, or educational resources that promote healthy lifestyles, disease prevention, and self-management of chronic conditions.

6) Health technology integration. Subscription-based health-care services often leverage health technology solutions, such as electronic health records, telemedicine platforms, and mobile health apps. These technologies can facilitate remote consultations, improve care coordination, and enhance access to medical information. In low-income countries, where physical infrastructure and health-care resources may be limited, health technology integration can bridge the gap and expand access to care.

7) Predictable revenue for providers. Subscription-based models can provide a stable revenue stream for health-care providers, particularly in low-income countries where fee-for-service models or insurance payment models may be unreliable. This stability can incentivise health-care providers to offer services in underserved areas, expand their capacity, and improve the quality of care.

Dr Ernest Madu, MD, FACC and Dr Paul Edwards, MD, FACC are consultant cardiologists for the Heart Institute of the Caribbean (HIC) and HIC Heart Hospital. HIC is the regional centre of excellence for cardiovascular care in the English-speaking Caribbean and has pioneered a transformation in the way cardiovascular care is delivered in the region. HIC Heart Hospital is registered by the Ministry of Health and Wellness and is the only heart hospital in Jamaica. Send correspondence to info@caribbeanheart.com or call 876-906-2107.