Five reasons why UAE firms should work with their medical providers

What’s the connection between the cost of healthcare and the need to have direct relationships with providers?

Quite simply, such a framework can play a considerable role in containing costs, with case studies out of the UAE showing a reduction of as much as 20 per cent in major areas of health spend among corporations who have shifted to such a model.

A big concern within the UAE healthcare system is a general lack of “healthcare gatekeepers”, and because of this, individuals exhibiting symptoms of even the most basic of conditions, such as a cough, for example, can visit a specialist and be administered tests rather easily. Indeed, in many cases it is far easier to receive potentially unnecessary consults and tests than to not receive them, and all of this is in large part due to the absence of proper mechanisms of control.

And so we should understand that one of the elements driving the success of the model of establishing closer provider ties is the ability to have a much higher level of control in this regard. Because outpatient consultations and diagnostics make up the majority of healthcare costs, a tighter provider network will allow a corporation far greater control, effectively reducing a large amount of those unnecessary costs.

There is of course more to it, and we’ll now take a closer look by focusing on five ways in which companies in the UAE are benefiting from a shift in their provider relationship approach.

1. Tackling excess absenteeism

With closer provider ties, frameworks for managing absenteeism are far easier to implement and monitor. In labour-centric work facilities in particular, an onsite doctor arranged through your provider network, or even as a first step a medical helpline, can help ascertain just how fit for work someone really is so that abuses are kept in check. And for the white-collar workforce the same level of control can be seen through those tighter relationships with the network physicians who again are part of the framework you have set up to better monitor and control absenteeism abuse.

2. Reducing the cost of medicines with a shift to generic

As part of an ongoing relationship with a healthcare provider or tighter network of providers, you can stipulate that only generic pharmaceuticals are used for treatment wherever possible. In the UAE, generic medications – which, to be clear, are just as effective as their branded counterparts – can cost 80-85 per cent less than the branded alternative, yet currently only account for 10 per cent of the market share.

3. Preventing abuse of services

As alluded to above, where there is no framework in place, an employee with something as minor as a mild sore throat can visit the local hospital, see an ear, nose and throat specialist, have various costly tests and treatments, and so on. While the individual is simply working within the system available to them, so too is the hospital or specialist. And knowing that the insurance company will pick up the tab, maximising revenue through whatever means necessary becomes a natural part of the provider’s way of running the business.

With closer provider ties, however, frameworks for addressing various minor health concerns in particular are much easier to establish and to communicate among your employees. And of course the providers in your network will want to play their part in reducing excessive consults and testing in their effort to keep the insurance premiums for you, their customer, more manageable.

4. Data for prevention

Claims data paints a vivid picture of a workforce’s health, allowing employers to identify healthcare trends and therefore invest efficiently and effectively in resources that will benefit their employees. According to the Dubai Health Authority (DHA), in 2012 only 6% of total medical expenditure was on preventive care. Companies need to step up here, and proper claims analysis is the first step.

Working with your healthcare providers more closely to review the data, this information can be used to implement highly focused wellness initiatives that address your company’s biggest health concerns, all with the very clear goal of initiating programs aimed at reversing the trend of your rising insurance premiums.

5. Better chronic disease management

Very much leading off of point five above, closer provider ties result in far better management of your chronically ill staff. While estimates vary, we can generally conclude that 80 per cent of healthcare costs come from 20 per cent of your staff (those with the poorest health). Working with your trusted healthcare partners to develop more effective ways of treating certain chronic illnesses – such as diabetes, hypertension, respiratory conditions, and others – will lead to better management of the conditions, therefore reducing the instances of flare-ups and in turn overall costs.

Improved care, serious savings

Let’s be clear that this is more than simply about saving you money. Building tighter relationships will, over time, allow you to work with your providers to address key issues that contribute to a better overall health offering. This includes everything from reducing waiting times, to quicker access to specialists where needed, to the co-implementation of more advanced preventive health programmes, to the establishing of helplines, and so on. Another way to look at it is that your providers, appreciating the business you are bringing them, will want to work with you to offer the best level of care possible.

And as for those savings, well, at the end of the day it is all very logical: A mutually-trusting relationship with your healthcare providers where all of your medical requirements are under one roof means you have closer links to the system – a system that you will be helping to shape – and as a result will have much tighter control on the purse strings. Indeed, consolidating your healthcare requirements with one or several providers could help save you in the region of 15-20 per cent, and in the face of globally rising premiums, that’s a serious sum.

Mark Adams is founder and CEO of Anglo Arabian Healthcare