ITIC MEA 2023 | Cost containment in MEA

The ITIJ team have been reporting from ITIC MEA 2023 in Abu Dhabi this week (15th May 2023) sharing the discussions that took place at the conference. Read all reports

Ahmed Monir, Founder of LGA Assistance Group,started off by asking if we should be looking at cost versus quality, or cost and quality. He discussed how there were no international protocols with regards to invoicing and what people can, and do, charge. LGA were able to identify and close the gap with a digital solution called HPASS. 

He added that 90 per cent of leaders would love to go explore digitalisation, but only 15 per cent are actually doing it right now. HPASS was able to save 49.01 per cent by working with the providers. One of the challenges was the provider satisfaction and he identified that you had to work really closely with your providers and manage their expectations and hear their concerns. They found the right balance between happy providers and happy clients through networking events and regular meetings.

Ian Cameron, ITIC Chairman asked that if you are looking to satisfy both the client and the provider, if the hospital has published prices, how does that pan out? 

Robin Ali said we suffer from believing that cost equals quality. Patients have no idea on quality-of-care outcomes, but what drives people to the hospitals, especially in the UAE, is the cost. People believe that if you pay more you will get better care, but that is not the case. Clients generally want the hospital groups with a global reputation like Mayo Clinic. He questioned what people are paying for – is it the plush surroundings, or better care? He supported that LGA are looking to drive the quality forward.

Dr Monir went on to talk about how LGA are evaluating what patients are receiving so that they know it is quality. He said the Gulf area is easy to evaluate because there are international check lists, completed by quality control departments and patient feedback that looks at all standards such as wait times, cleanliness of the facility, and professionalism of the medical teams.

Dr Jewel Abraham, Senior Director Revenue Cycle Management at Burjeel Holdings started his session by looking at the positioning of provider and payer. He said there are three provider streams – premier, speciality, and budget. The premier providers have high operational costs, they focus on high profit per case, and offer luxury and rare services. Speciality providers offer a balanced approach, they focus on mid- to low-end policies with customer-oriented care. And the budget providers focus on volume and an efficient use of resources.

Dr Abraham said that issues arise when a premier provider is treated as specialty provider.

He said that essentially it is a positioning game of numbers with issues taken into account including discounts – rejections – patient swapping and approval down-coding or upcoding.

He added that the customer wants zero waiting time, and then they want handholding or a full concierge service.  

Cameron asked if someone doesn’t like the hospitals which are offered, do they have the right to ask to go to Bangkok or London? Robin Ali confirmed that companies will send clients abroad if there is quality care for a better price, or on occasion if the quality is better outside of a region. Especially in Oncology in some regions.

Robin Ali, Head of Practice at The Consilient Consultancy Limited, looked at the challenges for cost containment and securing value for money, plus best practice for governments, regulators, insurers and claims administrators. He said no two countries are the same as they have differing cultures, social structures, access to technology, demographics and so on, which can also make things difficult.

He said there were many challenges for cost containment including a lack of transparency. He added that the government, regulators, insurers and claims administrators need to be more involved.