Challenges of Medical Insurance for Healthcare Providers

1
Challenges of Medical Insurance for Healthcare
Providers

• Robert Grey MA FCII
• Director Communications Development American
  Mission Hospital, Bahrain

2
Challenges of Medical Insurance for Healthcare
Providers

• Background Issues
• Strategic
• Financial
• Regulatory
• Future Developments
• Suggestions

3
Challenges of Medical Insurance for Healthcare
Providers

• Background Issues
• Increase in provision of medical insurance as an
  employee benefit
• Increase in numbers of insurance patients
• Increasing numbers of patients who are obese
  causing diabetes, heart disease etc
• Patients have more access to advice via internet
  and are better informed.
• Less likely to totally follow Doctors orders
• Patients are taking more of Doctors time
• Cost of medical staff and equipment continue to
  rise in excess of inflation

4
Challenges of Medical Insurance for Healthcare
Providers

• Strategic
• Improving medical care in GCC countries
• Develop scenarios for the next 10 15 years
• Oil gas prices produce income to develop health
  services, amongst others.
• World-wide shortage of qualified medical staff
• Increase in number of competitors for insurers
  and providers

5
Challenges of Medical Insurance for Healthcare
Providers

• Financial
• General perception among those outside the
  industry that medical business is profitable
  business for insurers and providers
• Significant increases in IT support are required
• Increases in number of processing staff required
• Delays in obtaining full settlement of claims

6
Challenges of Medical Insurance for Healthcare
Providers

• Regulatory
• Increase in rules and regulations designed to
  improve healthcare
• Changes in licensing procedures,
• Becoming more strict in general
• Introduction of compulsory medical insurance in
  GCC
• Move towards accreditation of medical facilities
  across GCC

7
Challenges of Medical Insurance for Healthcare
Providers

• Future Developments
• Greater use of packaged protocol to deal with 75
  of illnesses and complaints, standard procedures.
  
• Medical provider to identify non-standard claims.
• Company clients adopting more wellbeing, diet and
  fitness measures for staff to improve claims
  ratio, reduce sick-days.
• Continued improvement in patient knowledge.
• Need for improved care and specialist centers
  within GCC to deal with heart, cancer patients
  and diseases of longer living patients

8
Challenges of Medical Insurance for Healthcare
Providers

• Some Suggestions
• More regular meetings between providers and
  insurers
• Common Claim forms to save expense and time
• Common Agreements
• Exchange of Staff to encourage learning and
  understanding
• Common IT Systems
• Insurers should build in an annual basic health
  check for staff into their policy. To identify
  diseases at an earlier stage.

9
Challenges of Medical Insurance for Healthcare
Providers

• Observation
• Jointly we have the ability to influence the way
  that our customers look after their health by
  advising on the steps they can take to reduce
  risks to their health.
• For example a sensible diet, good eating habits,
  an exercise routine, regular check-ups, smoking
  cessation, cutting salt and sugar intake, driving
  safely.

10
Challenges of Medical Insurance for Healthcare
Providers

• Quotations from the US
• Benjamin Franklin
• God heals and the Doctor takes the fee
• Thomas Jefferson
• Health is worth more than learning
• Thank you and keep healthy