A major shift in the way the UAE's largest health insurer reimburses hospitals will dramatically improve the quality of care, a senior company official says.
Daman, the national health insurance company, announced on Saturday that it would adopt a new repayment system for hospitals and clinics - one based on results rather than simply prices.
Dr Jad Aoun, the chief medical officer at Daman, said the aim was to make sure the treatments the company were paying for were of a high quality.
Patients would end up with more and better information about hospitals, too, he added.
"We need to be more focused on the outcomes, which is what the patient ultimately wants and what we are paying for," he said in an interview. "Bad quality leads to increased cost."
Dr Aoun said much of the other data was already included on the electronic claim form.
The data will include basic information on the patient, such as age and sex, and also details on the success of the treatment.
Determination of success will be influenced by factors such as length of hospital stay, information on infections and unplanned admissions to the intensive-care unit within seven days.
"We previously concentrated on broad inspections of providers to ensure everybody in the network met basic international standards," he said.
"Now we would like to focus on the outcomes of the treatment performed in these hospitals.
"After assessing the data we may go back and restudy the price paid for the procedure to see if it reflects the quality of the outcome."
Hospital officials contacted by The National said they did not want to comment on the programme until they had more details. They were first told about it by a letter issued two weeks ago.
Daman has more than 1,400 contracts with health practitioners across the UAE. Some individual contracts cover a large number of premises, and more than 90 per cent of the health facilities in Abu Dhabi are included in the insurer's networks. Worldwide, it has more than 450,000 providers.
Currently, each facility in the network sends Daman an electronic claim detailing each procedure carried out on their cardholders. The company then pays the hospital based on a pre-agreed price list.
Facilities that fail to send the data required as part of the new arrangements could be penalised with reduced payments, Dr Aoun said. On the flip side, those that outperformed the prescribed standards might be rewarded.
He added that the information Daman collected would eventually be made public so patients could make more informed choices about where they sought treatment.
Dr Aoun referred to a study in the UK that showed most patients base decisions about where to get treatment on recommendations from friends, family or their doctors. Only five per cent relied on published facts.
"We may find out that there is a hospital which performs lots of a particular treatment but actually has very bad outcomes," he said.
Hospitals will be the first to come under the new scheme; smaller clinics and private practices will come next. Daman will meet providers over the next few months to discuss the details of the plans before they are implemented.
Some of Daman's more expensive policies cover treatment abroad at certain hospitals and clinics, but the new results-based system will not apply outside the UAE, Dr Aoun said.
The funding model is similar to those in other countries. Australia, for example, measures hospitals' performance and rewards them accordingly. Its system takes into account the types of patients hospitals see, so that like-with-like comparisons can be made.
Daman is also promising to ensure that benchmarks are fair for all providers.
"The Government expects us to achieve certain quality standards comparable to the best health systems throughout the world," Dr Aoun said. "To achieve an increase in quality, it is necessary to monitor quality."
munderwood@thenational.ae
Real estate tokenisation project
Dubai launched the pilot phase of its real estate tokenisation project last month.
The initiative focuses on converting real estate assets into digital tokens recorded on blockchain technology and helps in streamlining the process of buying, selling and investing, the Dubai Land Department said.
Dubai’s real estate tokenisation market is projected to reach Dh60 billion ($16.33 billion) by 2033, representing 7 per cent of the emirate’s total property transactions, according to the DLD.
At a glance
Global events: Much of the UK’s economic woes were blamed on “increased global uncertainty”, which can be interpreted as the economic impact of the Ukraine war and the uncertainty over Donald Trump’s tariffs.
Growth forecasts: Cut for 2025 from 2 per cent to 1 per cent. The OBR watchdog also estimated inflation will average 3.2 per cent this year
Welfare: Universal credit health element cut by 50 per cent and frozen for new claimants, building on cuts to the disability and incapacity bill set out earlier this month
Spending cuts: Overall day-to day-spending across government cut by £6.1bn in 2029-30
Tax evasion: Steps to crack down on tax evasion to raise “£6.5bn per year” for the public purse
Defence: New high-tech weaponry, upgrading HM Naval Base in Portsmouth
Housing: Housebuilding to reach its highest in 40 years, with planning reforms helping generate an extra £3.4bn for public finances
The White Lotus: Season three
Creator: Mike White
Starring: Walton Goggins, Jason Isaacs, Natasha Rothwell
Rating: 4.5/5
COMPANY PROFILE
Name: Kumulus Water
Started: 2021
Founders: Iheb Triki and Mohamed Ali Abid
Based: Tunisia
Sector: Water technology
Number of staff: 22
Investment raised: $4 million
Book%20Details
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Skewed figures
In the village of Mevagissey in southwest England the housing stock has doubled in the last century while the number of residents is half the historic high. The village's Neighbourhood Development Plan states that 26% of homes are holiday retreats. Prices are high, averaging around £300,000, £50,000 more than the Cornish average of £250,000. The local average wage is £15,458.
NO OTHER LAND
Director: Basel Adra, Yuval Abraham, Rachel Szor, Hamdan Ballal
Stars: Basel Adra, Yuval Abraham
Rating: 3.5/5
Key facilities
- Olympic-size swimming pool with a split bulkhead for multi-use configurations, including water polo and 50m/25m training lanes
- Premier League-standard football pitch
- 400m Olympic running track
- NBA-spec basketball court with auditorium
- 600-seat auditorium
- Spaces for historical and cultural exploration
- An elevated football field that doubles as a helipad
- Specialist robotics and science laboratories
- AR and VR-enabled learning centres
- Disruption Lab and Research Centre for developing entrepreneurial skills
States of Passion by Nihad Sirees,
Pushkin Press
MATCH INFO
Uefa Champions League quarter-final second leg:
Juventus 1 Ajax 2
Ajax advance 3-2 on aggregate
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BIGGEST CYBER SECURITY INCIDENTS IN RECENT TIMES
SolarWinds supply chain attack: Came to light in December 2020 but had taken root for several months, compromising major tech companies, governments and its entities
Microsoft Exchange server exploitation: March 2021; attackers used a vulnerability to steal emails
Kaseya attack: July 2021; ransomware hit perpetrated REvil, resulting in severe downtime for more than 1,000 companies
Log4j breach: December 2021; attackers exploited the Java-written code to inflitrate businesses and governments
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UAE cricketers abroad
Sid Jhurani is not the first cricketer from the UAE to go to the UK to try his luck.
Rameez Shahzad Played alongside Ben Stokes and Liam Plunkett in Durham while he was studying there. He also played club cricket as an overseas professional, but his time in the UK stunted his UAE career. The batsman went a decade without playing for the national team.
Yodhin Punja The seam bowler was named in the UAE’s extended World Cup squad in 2015 despite being just 15 at the time. He made his senior UAE debut aged 16, and subsequently took up a scholarship at Claremont High School in the south of England.
COMPANY%20PROFILE%20
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The specs
Engine: 3.0-litre six-cylinder turbo
Power: 398hp from 5,250rpm
Torque: 580Nm at 1,900-4,800rpm
Transmission: Eight-speed auto
Fuel economy, combined: 6.5L/100km
On sale: December
Price: From Dh330,000 (estimate)
How to watch Ireland v Pakistan in UAE
When: The one-off Test starts on Friday, May 11
What time: Each day’s play is scheduled to start at 2pm UAE time.
TV: The match will be broadcast on OSN Sports Cricket HD. Subscribers to the channel can also stream the action live on OSN Play.
