ITIC Global 2023 | Provider Network Forum
Hosted by Laura Hilton, Co-Founder of Fairmount International, this event brought together payers and providers to discuss the important topics in the industry
The ITIJ team have been reporting live from ITIC Global in Barcelona this week (November 2023) sharing the discussions that took place at the conference. Read all reports
Lynne Fung, Executive Director of Business Development at Matilda International Hospital, spoke about healthcare in China. She said that the public and private sectors complement each other under a well-established dual-track healthcare system. She said that China achieves near-universal coverage through the provision of publicly-funded medical insurance. This covers both western and Chinese medicine.
Fung went on to say the aims of healthcare are to provide quality care; enhance patient experience; and manage costs – all of which create value.
She said there are ways of measuring outcomes through clinical risk management systems and clinical audits; with specialist review committees; through regulatory body inspections; by looking at key performance indicators; and through clinical accreditation.
Fung talked about managing costs, and said that organisational efficiency is very important, continuing that it is key to think about maximising purchasing power; financial controls and audits; prudent spending; and appropriate and flexible staffing. She added that, to look at managing costs, it is necessary to consider bundled care packages – which includes negotiating specialist fees and price transparency. Finally, she said, technology – such as data aided decisions and streamlining systems – is essential.
Dr Antika Jacqueline Klein, Director of Bangkok Hospital Headquarters, went on to talk about the healthcare system in Thailand. She said that the private sector is heavily regulated, and needs to comply to the regulations of the Ministry of Health; the Ministry of Commerce; the Office of Insurance Commission; and the Thai Medical Council. She said they also now have to comply with strict regulations about patient privacy.
Klein went on to talk about the new standard items for medical billing (SIMB) in the country. She said it has taken since 2018, when the announcement of these new rules came out, for things to be implemented, and said that invoices will now have different terminology and formatting to be in compliance with the new law. Adding that this can be challenging for teams.
Klein said that cooperation between payors and providers is vital. She spoke about the difficulties they sometimes face because of time differences and language barriers.
Mark Smith, Associate Director for Marketing, International, and Private Medical Insurance from The London Clinic, talked about value-based healthcare (VBH), and asked if it can work in the international insurance market.
He said to evolve to a value based system you must reorganise care around patient conditions, into integrated practice units; measure your outcomes and costs for every patient; move to value-based reimbursement models, with the ultimate aim of bundling payments for conditions; integrate and coordinate a multi-site care delivery system; allocate care across geographies to improve value – the right care in the right location; and underpin all of this with an IT technology platform that acts as an enabler.
Smith then spoke about the advantages and limitations of VBH. He said the advantages are that it is based upon evidence-led pathways; there is efficiency of service access; it reduces patients’ exposure to unexplained cost variation; allows for patient payment for delivery of clinically justifiable treatment; it is a compelling sales story.
He said the concerns about VBH are it comes from one of the most expensive healthcare markets in the world; the premise of capturing the full cycle cost of care does not translate directly to the international market and nor does the tracking of end-to-end outcomes; and that volume is essential to make it viable.
Smith ended by asking if VBH can work in the international expat insurer markets. He said that, in the UK, insurers have already sought to extract chunks of care from contracts and manage costs via network delivery. He added that they have already selected elements of VBH principles that can easily be applied.