The Bermuda Health Council is looking at alternative payment models amid concerns that patients are not always getting “bang for their buck”.

According to health economist Ricky Brathwaite, life expectancy is not on par with the amount of money being spent and affordability is still a growing problem.

Speaking at the Summer Leadership Conference this morning, he told healthcare leaders at The Fairmont Southampton: “If you’re going to spend a lot of money, you expect your life expectancy to increase or it to be top-notch. What we’re seeing is that our life expectancy here in Bermuda is not on par with the amount of money that we are spending in the same way that is going on in the US.

“We’re spending a lot of money, but we’re not getting the bang necessarily for the buck that we’re spending, which has led to this whole idea of moving from this fee-for-service to more interesting or alternative payment models that really reward performance and value for payment.”

He added that affordability is “becoming a bigger and bigger issue”, with segments of the population unable to afford the cost despite the Bermuda Government putting a lot of money into healthcare.

According to Dr Brathwaite, the average annual healthcare expenditure in 2013 was $11,000 per person, which is “probably three or four times what an average island nation would have”.

He said: “It’s an unsustainable thing that we are looking to reverse.”

Dr Brathwaite, who explained the role of the health council and gave an overview of Bermuda’s healthcare system, said 35 per cent of the population has a chronic condition and 13 per cent has diabetes, compared with the global average of 8.9 per cent.

He also noted Bermuda’s ageing population, adding that by 2050, an estimated 25 per cent of the population would be over 65 and more than 50 per cent would be over 40.

“Our expenditure really starts ramping up around 40 to 45 years old and it goes up exponentially,” he said.

“As the curve shifts to the right, as we age as a population, what we’re going to see is a lot more expense and so we need to figure out now how we are going to deal with that proactively rather than wait and say ‘we should have done that ten years’ ago.”

With long-term care costs also a burden, he welcomed input on how the model could be changed from one that says “the healthcare system should take care of an individual versus ageing at home in a more convenient, familiar place”.

He added: “We’re looking at models on how to do that. It is a struggle to figure out the sweet spots of how to engage the public, get everyone involved and reduce cost at the same time, while maintaining the quality of care that is needed for some of these individuals who may have complex needs.”

The Summer Leadership Conference runs until Friday and is co-ordinated by the New York chapter of the American College of Health Care Administrators and the New York State Health Facilities Organisation/New York State Centre for Assisted Living.