ITIC APAC 2023 | Cost containment and patient management in Asia-Pacific

The ITIJ team have been reporting from ITIC APAC 2023 in Sydney this week (18-20 June) sharing the discussions that took place at the conference. Read all reports

David Burns, Chief Executive Officer at First Assistance began by noting that the Asia-Pacific region is ‘diverse’. He explained: “Its healthcare facilities vary greatly – medical facilities range from non-existent to world-class, and evacuations are common because of the diversity in landmasses, the number of islands. And there is a shortage of working infrastructure.”

He argued that the broader Asia-Pacific region could be divided into separate sub-regions according to the model of healthcare that is used. These include:

• Australia and New Zealand – Predominantly a public healthcare system with set fees, with elective private health options that operate on quotations
• ‘Tourist Asia’, including India, Indonesia, Nepal, Malaysia, Philippines, Thailand, and Vietnam – A predominance of private healthcare options in ‘tourist’ areas, and more ‘limited’ public healthcare in non-tourist areas. Generally reasonable medical costs, but with a risk of over-treatment or exaggerated charges
• Hong Kong, Japan, Singapore, South Korea – Well developed public and private sector healthcare, with some direct negotiation possible with private hospitals – but with a higher average cost
• China – Extensive public healthcare system, but with difficult language and cultural barriers to navigate, alongside expensive private hospitals in major cities, and ‘alternative’ medical treatments. Challenges around cashless payments, as well as access for repatriation
• South Pacific, including Papua New Guinea, Fiji, Tahiti, Noumea, Rarotonga, Vanuatu, Samoa, and Tonga – Remote islands with little to no medical care, a lack of cashless payment options, a high number of tourists and cruise ships, and a heavy reliance on medical evacuations

Burns continued that there are many techniques and strategies to ensure that costs are contained.

This included identifying the medical facts and making decisions on that basis to combat ‘unnecessary treatment’, and potentially arranging for a repatriation by commercial flight or private air ambulance if necessary.

While not necessarily cheap, Burns argued that getting the patient home was generally much cheaper than leaving them abroad, where they may ‘get worse or incur additional costs’. However, he warned that it is important to consider the availability of transfer options – in some regions, such as the South Pacific, commercial flights may not be an option, for example.

Burns emphasised the importance of having a strong network of trusted providers to help navigate challenges. For example: “In China, if you have a high-cost case … it is very difficult to get insights into what’s going on. But if you have a good partner on the ground, you will be able to understand why things are costing what they are, what the options are, and how you can negate some of those costs.”

However, he added that an appropriate level of due diligence was critical to ensuring that local partners were competent and honest. Burns also recommended being proactive in negotiating  with partners, and agreeing contracts in advance of any emergencies. Likewise, it is important to challenge inappropriate charging when detected.

Likewise, having more partners of the same type in a network allows providers to create ‘price tension’ and negotiate better rates. Beyond this, many partners offer special rates to preferred partners.