Non-Insured Health Benefits Program - Annual Report 2011/2012

2011/2012 Annual Report Summary

The 2011/2012 Non-Insured Health Benefits (NIHB) Program Annual Report, now in its 18th edition, provides national and regional data on the Program's eligible client population, expenditures, and benefit utilization. The Annual Report also provides an update on NIHB's efforts in the area of client safety.

Client Population:

• The total number of eligible clients at the end of March 2012 was 896,624, an increase of 6.0% from March 2011. This significant increase in the number of clients can be attributed to the creation of the new Qalipu Mi'kmaq First Nations band and to new clients joining the Program through Bill C-3.
• From March 2011 to March 2012, the Atlantic region experienced the highest percentage change in the total number of eligible clients at a 65.2% increase, which can be attributed to the registration of 21,419 new Qalipu Mi'kmaq First Nations clients.
• Of the 896,624 total eligible clients at the end of the 2011/12 fiscal year, 855,009 (95.4%) were First Nations clients while 41,615 (4.6%) were Inuit clients.

Expenditures:

• In 2011/2012, total NIHB expenditures were $1,074.3 million, up 4.5% or $46.3 million from 2010/2011 to 2011/2012. This growth is slightly higher than the 3.9% annual growth increase recorded in 2010/11.
• Of the $1,074.3 million, NIHB Pharmacy costs (including medical supplies and equipment) represented the largest proportion at $459.4 million (42.8%), followed by NIHB Medical Transportation costs at $333.3 million (31.0%) and NIHB Dental costs at $219.1 million (20.4%).
• The highest net growth in expenditures over fiscal year 2010/11 was in medical transportation benefits at $21.5 million, followed by pharmacy benefits which increased by $18.6 million.
• NIHB Dental expenditures recorded an artificially low rate of growth at 1.5%.  This is due to administrative issues relating to the transition to a new claims processor and the implementation of a new financial activity code structure at Health Canada.
• In 2011/2012, the Manitoba Region had the highest expenditures with $219.0 million, accounting for 20.4% of all NIHB expenditures, followed by the Ontario Region at $180.8 million (16.8%), and the Saskatchewan Region at $161.3 million (15.0%).
• In comparison, the lowest expenditures were in the Yukon ($11.2 million) and the Northwest Territories ($27.7 million).  These totals represented 1.0% and 2.6% respectively of the national total.
• The Atlantic Region experienced the highest expenditure growth rate over the last fiscal year at 14.3%.  This increase in expenditures can be attributed to the registration of the new Qalipu Mi'kmaq First Nations clients who became eligible to receive benefits through the NIHB Program.

Utilization:

• In 2011/12, the national utilization rate was 62% for NIHB Pharmacy benefits paid through the Health Information and Claims Processing Services (HICPS) system.  This is slightly lower compared to the previous four fiscal years.  Pharmacy utilization rates vary across the regions.  In 2011/12, regional rates ranged from 45% in Nunavut to 71% in Saskatchewan.
• The national utilization rate for dental benefits paid through HICPS, in 2011/12, was 36%.  This is a decrease of one percentage point from 2010/11.  National NIHB Dental utilization rates have remained relatively stable over the past five years.  The highest dental utilization rate was in the Quebec region (44%) and the lowest rate was in the Atlantic Region (28%).  Over the two year period between 2010/11 and 2011/12, 436,209 distinct clients received NIHB Dental benefits resulting in an overall 49% utilization rate over this period.