ITIC Americas 2026 | Building the right network – meeting the needs of insurance payers

The ITIJ team have been reporting live from ITIC Americas in Mexico this week (June 2026) sharing the discussions that took place at the conference. Read all reports

Dr Carlos Jorge González Flores, Medical Team Manager Mexico, Allianz Canada

Dr Flores started his presentation by talking about how they approach their Hospital Evaluation Program (HEP): “We maintain close relationships with an extensive network of hospitals and medical facilities around the globe to ensure travellers receive the care they need in an emergency.” He said they use a market-leading quality-verification initiative and that the evaluations are performed on-site by Allianz medical staff, plus they have regular provider re-evaluations.

When a patient is either at, or en route to, a hospital, the medical team conducts a comprehensive facility review, which encompasses the following aspects:

• Classification of the facility (1st, 2nd, or 3rd level)
• Internal HEP scoring (1–5)
• Status as a private or public institution
• Capability to provide appropriate treatment
• Required specialties
• Infrastructure availability
• Availability of specific treatments and diagnostics
• Existing contractual agreements with the hospital.

He added that Allianz’s Internal Global Network Providers (GNP) “enable us to preferentially direct customers to facilities that have met the high standards set by Allianz Partners”.

Dr Flores went on to talk about the HEP, and said they first have an internal quality measurement, which evaluates the proficiency and quality of healthcare facilities, offering a standardised rating comprehensible to the business. Then they have a selection process for targeted countries and facilities.

He than talked us through their extrensive HEP evaluation grid/questionnaire.

Dr Flores went on to talk about choosing medical providers for air Ambulance services, most of which is determined by the medical team. He said criteria for selecting an air ambulance provider include: clinical appropriateness; provider capability; operational readiness; internal provider reviews.

He added that provider adherence criteria for air ambulance services include pathology needs; medical equipment; aircraft range; availability and route; accreditation and vetting.All providers are checked in the internal GNP database. Dr Flores then spoke about the process for vetted providers versus the process for non-vetted providers, adding: “Approval is granted once reviews are completed and meet approver thresholds.”

Aishell Sanchez Gonzalez, Head of International Business Development at Fundación Santa Fe de Bogotá

Sanchez started by talking about the common operational breakdowns between payers and hospitals and said they are:

• Delayed medical updates
• Lack of a single operational contact
• Unclear financial escalation
• Slow estimates and billing disputes
• Limited international coordination
• Language and cultural barriers
• Discharge planning delays
• Fragmented communication layers.

She said the challenge in global networks is rarely clinical quality alone – it is operational predictability. She added “In this environment, accreditation becomes a common language.
It reduces uncertainty and provides reassurance when distance exists between the patient and the provider.”

Sanchez said accreditation is not the goal – that it is the framework to consistently deliver safe, predictable, high-quality care, adding that accreditation “should be the starting point – not the final differentiator”.

Sanchez then spoke about the paradigm shift from baseline to imperative. She said the baseline (standards and basic safety) is where:

• Accreditation is viewed as a simple certificate on the wall
• Compliance-driven processes focused primarily on regulatory checkmarks
• Standardised clinical management detached from real-time payer data exchange.

She said the imperative (operational maturity and responsiveness) is where:

• Deep organisational transformation drives institutional culture
• Globalised quality benchmarks are linked directly to high-complexity performance
• Humanisation of care is verified by elite metrics (Planetree Silver/Gold paths)
• Sustained ecosystem integration actively protects payer Medical Loss Ratios (MLR).

She said what international payers expect from hospitals are clinical confidence, operational responsiveness, financial transparency, patient continuity and ecosystem coordination.

Hospitals must coordinate beyond clinical care, said Sanchez, explaining that international payers increasingly value hospital partners capable of reducing operational fragmentation and coordinating the full patient journey beyond medical treatment itself. Beyond accreditation, payers are measuring clinical metrics, operational metrics and relationship metrics.
 

Sanchez concluded by saying that quality is proven during a crisis, and that what global payers and assistance boards value most when critical or unexpected clinical situations arise are “transparency, rapid escalation, governance maturity, corrective action, and honest communication”.

She said that while accreditation helps hospitals enter global conversations, operational excellence, transparency, and coordination are what sustain international payer relationships.

Heather Petrie, Director of Quality & Safety, & Project Management, Airmedic

At the start of her presentation Petrie asked: “The accreditation is over.​ Now what? Are we learning, sharing, and improving from what ​we measure?”

She said accreditation is driving quality assurance (QA), and that every country prescribes its own QA and safety management system (SMS) regulatory programmes – from maintenance audits alone, to full aviation operations. Petrie stated that the metrics that matter most are price, availability, care, transparency, and outcomes.

Petrie went on to look at risk management, and said there are two streams of risk – operational and medical. Operational and medical risk both start with a pre-flight assessment – measured, not assumed.​

Insurers and assistance companies request the same dossier from providers, noted Petrie, adding, however, that the dossier is rarely the right question set.

What’s typically asked for:
- Accreditation certificates (EURAMI, CAMTS, NAAMTA)
- Insurance certificates and operating licences
- Fleet list and base locations
- Medical director credentials and CV
- Crew credentials – aviation and medical​
- Training matrix: aviation and medical
- Customer satisfaction report
- Accident and incident reports.

What’s rarely asked for:

• AOG% by aircraft, plus fleet renewal plan
• Mission diversions due to mechanical
• Non-punitive safety report rate (per 1,000 hrs)
• Internal audit findings and CAPA closure
• Last regulatory inspection finding and CAPA
• Adverse events and near-miss reports.

Petire concluded with an important message for all air medical providers and payers: “We can all publish a glossy annual report, but the three questions every partner should ask are: when was your last adverse event or near miss?​; show me a mission that ran long; who on your team can I call? If the answer is a brochure, it isn't transparency.​”

To finish, Petrie said to remember that: QA is operational, not ceremonial; share the data that's hardest to share; and build the partnership on what happens when missions go sideways.