ABU DHABI // The UAE's largest health insurer has introduced a repayment system it says will bring down the cost of insurance by cutting down on unnecessary tests and treatments given to hospital patients.
Daman, the national health insurance company, announced yesterday that its Diagnosis Related Groups billing system would reimburse hospitals and clinics the average cost of treating a particular diagnosis - rather than the actual cost of each patient. There will be a cap on payment for each diagnosed condition.
It is hoped the system will force doctors to think more carefully about what treatments are essential for their patients, but critics fear it could dissuade them from ordering tests that could prove crucial out of fear they would not be covered.
Although the system currently applies only for holders of Daman's basic insurance, it will be extended to all policies - including Thiqa, the free insurance provided to Emiratis - by the end of next year.
Dr Jad Aoun, Daman's chief medical officer, claimed the change would not deprive any patients of services.
"There will be no change felt by either the patient or the doctor other than a dramatic improvement in health care," he said. "This will only affect hospitals, who will be forced to become more transparent and efficient. We will pay hospitals package cost, and they have to manage within this package. So if they go spending more than the package allowance, they will be the ones losing money."
He said hospitals would be under greater pressure to manage the cost of their patients and that it would also make hospital negotiations with patients clearer.
Ultimately, said Dr Aoun, the process should help to keep insurance costs down.
However, Allison Ramsay, the managing director of Al Rawdah German Medical Centre in Abu Dhabi, warned there could be mixed results.
"The good thing is that it will make doctors think carefully about what investigations and what treatments they are going to go with because of the worry about financial reimbursement," she said.
"On the other hand, it would be a bad thing if some doctors begin to avoid doing a test that might later prove crucial, just because they are worried it will not be seen as necessary and not fall under the reimbursement cap."
Hospitals that accept Daman Basic Insurance cards have already started using the new system.
A consultant at Mafraq Hospital in Abu Dhabi said that although the system was complicated and would require extra paperwork, it was likely to prove "very beneficial" to government-run hospitals.
"There are a lot of things that government hospitals do not bill for, because they are funded by the Government," he said.
"Since that is being phased out and hospitals will have to pay for themselves by 2013, this means that we can now bill for things like admission to the intensive care unit, which we never did before."
He said little would change for doctors practising correctly.
"If anything, this will force doctors to stop giving patients unnecessary tests and ultrasounds and so on just to protect their backs, even if the patient doesn't need it," he said.
Dr Ahmed Shanker, a paediatrician at Mora Medical Centre in the capital, said it would also stop patients demanding unnecessary tests unless they were prepared to pay. "Some patients think they are the doctors, and demand extra scans even if the doctor insists they don't need it," he said.
Countries including the US, Germany, Australia and Singapore use similar systems.
hkhalaf@thenational.ae
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How to protect yourself when air quality drops
Install an air filter in your home.
Close your windows and turn on the AC.
Shower or bath after being outside.
Wear a face mask.
Stay indoors when conditions are particularly poor.
If driving, turn your engine off when stationary.
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Key findings
- Over a period of seven years, a team of scientists analysed dietary data from 50,000 North American adults.
- Eating one or two meals a day was associated with a relative decrease in BMI, compared with three meals. Snacks count as a meal. Likewise, participants who ate more than three meals a day experienced an increase in BMI: the more meals a day, the greater the increase.
- People who ate breakfast experienced a relative decrease in their BMI compared with “breakfast-skippers”.
- Those who turned the eating day on its head to make breakfast the biggest meal of the day, did even better.
- But scrapping dinner altogether gave the best results. The study found that the BMI of subjects who had a long overnight fast (of 18 hours or more) decreased when compared even with those who had a medium overnight fast, of between 12 and 17 hours.
A new relationship with the old country
Treaty of Friendship between the United Kingdom of Great Britain and Northern Ireland and the United Arab Emirates
The United kingdom of Great Britain and Northern Ireland and the United Arab Emirates; Considering that the United Arab Emirates has assumed full responsibility as a sovereign and independent State; Determined that the long-standing and traditional relations of close friendship and cooperation between their peoples shall continue; Desiring to give expression to this intention in the form of a Treaty Friendship; Have agreed as follows:
ARTICLE 1 The relations between the United Kingdom of Great Britain and Northern Ireland and the United Arab Emirates shall be governed by a spirit of close friendship. In recognition of this, the Contracting Parties, conscious of their common interest in the peace and stability of the region, shall: (a) consult together on matters of mutual concern in time of need; (b) settle all their disputes by peaceful means in conformity with the provisions of the Charter of the United Nations.
ARTICLE 2 The Contracting Parties shall encourage education, scientific and cultural cooperation between the two States in accordance with arrangements to be agreed. Such arrangements shall cover among other things: (a) the promotion of mutual understanding of their respective cultures, civilisations and languages, the promotion of contacts among professional bodies, universities and cultural institutions; (c) the encouragement of technical, scientific and cultural exchanges.
ARTICLE 3 The Contracting Parties shall maintain the close relationship already existing between them in the field of trade and commerce. Representatives of the Contracting Parties shall meet from time to time to consider means by which such relations can be further developed and strengthened, including the possibility of concluding treaties or agreements on matters of mutual concern.
ARTICLE 4 This Treaty shall enter into force on today’s date and shall remain in force for a period of ten years. Unless twelve months before the expiry of the said period of ten years either Contracting Party shall have given notice to the other of its intention to terminate the Treaty, this Treaty shall remain in force thereafter until the expiry of twelve months from the date on which notice of such intention is given.
IN WITNESS WHEREOF the undersigned have signed this Treaty.
DONE in duplicate at Dubai the second day of December 1971AD, corresponding to the fifteenth day of Shawwal 1391H, in the English and Arabic languages, both texts being equally authoritative.
Signed
Geoffrey Arthur Sheikh Zayed
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Israel Palestine on Swedish TV 1958-1989
Director: Goran Hugo Olsson
Rating: 5/5
Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.
Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.
“Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.
Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.
“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.
Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.
From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.
Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.
BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.
Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.
Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.
“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.
Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.
“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.
“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”
The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”