9th healthcare insurance forum, dubai, uae
DESCRIPTION
WELCOME TO THE HEALTHCARE INSURANCE FORUM! Insurance privatisation is a new landscape for regional providers. It has extended a horizon of opportunities. Primarily, Insurance revolved around three models; integrating with the government, market led dictated by competition and a brown field transition from the ground up. IIR Middle East's Healthcare Insurance Forum is an 8 year success story; a platform for interactive debate to identify opportunities this industry could benefit from. These discussions often lead to policy and framework implementation. Best practices are then shared across the region. To raise the benchmark this year, research has helped guide us in engaging Healthcare's most important stakeholder – it's customer! We have therefore chosen – The Customer Experience – as the theme for the 9th Healthcare Insurance Forum, which will be held 26 – 29 January 2014 at the Dusit Thani Hotel, Dubai. Led by a pre and post Forum workshop the two day conference will focus on: ROI enhancing Cost Containment Improving Provider Relations Understating The Buyer's Perspective By addressing wellness this Forum aims to nurture a society which prides it's health and revisit the core foundations Insurance was introduced for – Creating a Healthier population! As an integral stakeholder in the Healthcare Insurance landscape, we look forward to your participation in pioneering this trend.TRANSCRIPT
The Customer Experience
www.iirme.com/healthcareinsurance
� The corporate perspective
� Improving provider relationships
� Addressing population health and wellness
� MENA compatibility within policies
� Niche opportunities in a competitive market
� Accelerate ROI via cost containment
� Workshops
• Disease Management
• Medical Tourism - Centers of Healthcare Excellence
• Coding
• Healthcare Fraud Typology
WHAT’S NEW FOR THIS YEAR?
REGISTER BEFORE29 DECEMBER 2013 AND SAVE US$1,190
26-29 January 2014 • Dusit Thani Hotel, Dubai, UAE
- Gain a 360 degree perspective: Payer - Provider - Buyer - Corporates
- Relate Insurance payouts to wellness and population health
- Assess a future revenue stream – Medical Tourism
- Identify the niche differentiator for profitability in a competitive market
- Align cost containment to a progressive business agenda
- Optimise performance via data utilisation in RCM
- Implement a fraud control process within payouts
See inside for more…
FORUM HIGHLIGHTS EXPERT SPEAKER FACULTY
Gerhard BeckerFormer Managing Director
University Hospital Dusseldorf
Germany
Husein RekaManager Health Insurance,
Supreme Council of Health Qatar
Linda van DijkDirector Medical Strategy & Development department
DAMANUAE
David T YoussefCEO
Now HealthUAE
Dr Sven RohteChief Commercial Officer
DAMANUAE
Imane AlaouiBenefits Manager, Middle
East, SchlumbergerUAE
Dr Cother HajatAdjunct ProfessorUAE University
UAE
Feryal Kazim MDExternal Insurance
ConsultantUAE
Husam Majali MDMarket Access Lead – Private
Insurance and PricingMerckUAE
Karen Carbone MD MBA Group COO Medical
OperationsSEHAUAE
Paul VinckeManaging Director, European
Healthcare Fraud and Corruption Network EHFCN,
Belgium
• Ghazal Siddiqi, Head of Provider Management, Supreme Council of Health, Qatar
• Mary Shuab, Former Director Revenue Cycle Management, HAAD, UAE
• Rasha Moukayed, Manager - Life & Medical, Guardian Insurance Brokers, UAE
• Renée-Marie Stephano, JD, President, Medical Tourism Association, Chief Editor, Medical Tourism Magazine, USA
• Sarry Al Buraik, Advisor to CEO, King Fahad Medical City, KSA
and many more…
#HealthcareInsuranceME
Organised ByPlatinum Sponsor
Dear Insurance Executive,
Insurance privatisation is a new landscape for regional providers. It has extended a horizon of opportunities. Primarily, Insurance revolved around three models; integrating with the government, market led dictated by competition and a brown field transition from the ground up.
IIR Middle East’s Healthcare Insurance Forum is an 8 year success story; a platform for interactive debate to identify opportunities this industry could benefit from. These discussions often lead to policy and framework implementation. Best practices are then shared across the region.
To raise the benchmark this year, research has helped guide us in engaging Healthcare’s most important stakeholder – it’s customer! We have therefore chosen – The Customer Experience – as the theme for the 9th Healthcare Insurance Forum, which will be held 26 – 29 January 2014 at the Dusit Thani Hotel, Dubai.
Led by a pre and post Forum workshop the two day conference will focus on:• ROI enhancing Cost Containment• Improving Provider Relations• Understating The Buyer’s Perspective
By addressing wellness this Forum aims to nurture a society which prides it’s health and revisit the core foundations Insurance was introduced for – Creating a Healthier population!
As an integral stakeholder in the Healthcare Insurance landscape, we look forward to your participation in pioneering this trend.
Kind regards,
Sally CoranderDivisional Manager
T: +971 4 335 2437 | F: +971 4 335 2438 | E: [email protected] | W: www.iirme.com/healthcareinsurance
CONFERENCE CHAIR:Dr Finn Goldner, Director, True Codes Consultancy, Germany
WORKSHOP LEADERS:Paul Vincke, Managing Director, European Healthcare Fraud and Corruption Network EHFCN, Belgium
Renée-Marie Stephano, JD, President, Medical Tourism Association, Chief Editor, Medical Tourism Magazine, USA
MODERATORS:Dr Cother Hajat, Adjunct Professor, UAE University, UAE
Dr Saif Al Jaibeji, Vice President, Aetna, UAE
Husam Majali MD, Market Access Lead – Private Insurance and Pricing, Merck, UAE
Dr Finn Goldner, Director, True Codes Consultancy, Germany
KEYNOTES:Dr Cother Hajat, Adjunct Professor, UAE University, UAE
Dr Mansoor Anwer, Director, Occupational and Medical Health, du, UAE
Dr Saif Al Jaibeji, Vice President, Aetna, UAE
Dr Sven Rohte, Chief Commercial Officer, DAMAN, UAE
Imane Alaoui, Benefits Manager, Middle East, Schlumberger, UAE
Paul Vincke, Managing Director, European Healthcare Fraud and Corruption Network EHFCN, Belgium
Renée-Marie Stephano, JD, President, Medical Tourism Association, Chief Editor, Medical Tourism Magazine, USA
Sarry Al Buraik, Advisor to CEO, King Fahad Medical City, KSA
EXPERT SPEAKER FACULTY
ONE ON ONEMeet and interact with Visionary Payors over a live discussion. Tweet your questions live to #Healthcareinsurance as you hear them speak.
STAKEHOLDER FACETIME Enjoy face time with internationally ranked Provider and Payor CEOs over an informal connection.
360 DEGREE PANEL DISCUSSIONS Join in the debate with: Payors/Providers/Regulators/Corporates
SPEAKER HOSTED LUNCH Meet each speaker in person. Have your questions answered and share insights over a hearty meal.
Networking ActivitiesMore networking than ever before to ensure better interaction and shared learning
WELCOME TO THE HEALTHCARE INSURANCE FORUM!
Monday | 27th January 2014CONFERENCE DAY ONE
T: +971 4 335 2437 | F: +971 4 335 2438 | E: [email protected] | W: www.iirme.com/healthcareinsurance T: +971 4 335 2437 | F: +971 4 335 2438 | E: [email protected] | W: www.iirme.com/healthcareinsurance
8.50 Welcome and Opening Remarks Investigating the Latest Updates and Trends in the Healthcare Insurance Landscape
Dr Finn Goldner, Director, True Codes Consultancy, Germany
STRATEGY 9.00 Benefits of Regional Healthcare Insurance and it’s
Implications on Population Health and Wellness This presentation will focus on a national implementation
plan with NCD (non-communicable disease) as it’s focus towards prevention and wellness.
Speaker Faculty Reserved
OPPORTUNITIES 9.15 Corporate Customers: What do they really want out of
health insurance? The insurance industry seeks better health and ease of
access to healthcare. Corporates are integral stakeholders within the insurance landscape. Their role in changing life style patterns of their employees will be shared in this presentation.
Dr Sven Rohte, Chief Commercial Officer, DAMAN, UAE
9.30 Opportunities for Insurers in the wider MENA region Privatisation brings with it new opportunities. Understanding
them will extend growth to generate economies of scale. Dr Saif Al Jaibeji, Vice President, Aetna, UAE 9.45 The growing integration of medical tourism and health
insurance policies in the GCC and Middle East The opportunity to establish ‘Centres of Excellence’ is ripe
in the region. How can stakeholders align their business agenda to attain these goals?
Renée-Marie Stephano, JD, President, Medical Tourism Association, Chief Editor, Medical Tourism Magazine, USA
REGIONAL PERSPECTIVE10.00 The new mandatory health insurance scheme in Qatar:
Lessons learnt Recent healthcare development in Qatar has witnessed a
new spectrum for the insurance industry. What lessons can regional payors take away from this experience?
Husein Reka, Manager, Health Insurance, Supreme Council of Health, Qatar
10.15 Recent Developments and Opportunities for Private Insurers in the Saudi Market
The integral role of a private insurance landscape always compliments neighbouring markets. This session identifies synergy between regional insurers within the GCC.
Ingo Pischetsrieder, COO, Saudi Enaya, KSA
10.30 Providing a Federal Perspective for the UAE Compatibility within a nation is instrumental to a unified
payment platform. How can regulators lead in extending insurers uniformity?
10.45 Coffee and Networking Break
CONSENSUS PANEL11.30 This panel will summarise the Regional Perspective and
reach consensus on a strategy to align moving forward Dr Sven Rohte, Chief Commercial Officer, DAMAN, UAE Renée-Marie Stephano, JD, President, Medical Tourism
Association, Chief Editor, Medical Tourism Magazine, USA Husein Reka, Manager Health Insurance, Supreme Council
of Health, Qatar Ingo Pischetsrieder, COO, Saudi Enaya, KSA
Led by: Dr Finn Goldner, Director, True Codes Consultancy,
Germany
COST CONTAINMENT12.00 Surviving in a competitive market: What does it take for a
health insurer to be profitable Competition can create opportunities for growth, otherwise
overlooked in a monopoly. Is innovation the answer?
12.15 Medical Inflation and Cost Control: Regulatory Perspective and Containment Approach
This session discusses the regulators perspective on operational efficiency and optimising processes to lower cost and mitigate risk.
Lina Jichi, Head of Health Financing, Monitoring and Advisory – Strategy, HAAD, UAE
12.30 Fighting Fraud in Healthcare. Is it really worth the effort? This presentation focuses on prejudice and argument,
possibly doubting benefits and ROI of counter fraud in healthcare. International references to successes ánd difficulties encountered in different healthcare systems from around the world will underpin these arguments.
Paul Vincke, Managing Director, European Healthcare Fraud and Corruption Network, EHFCN, Belgium
12.45 Lunch and Networking Break
14.00 Innovative partnerships in Improved Drug access with better cost containment in Private Insurance
The drug cost in insurance claims can be reduced by new technologies and new agreements to address this major cost driver in health insurance
Husam Majali MD, Market Access Lead – Private Insurance and Pricing, Merck, UAE
14.15 Innovative Approaches Using Data and Technology by Insurers
As the largest insurer what lessons can we learn from their innovative approach in utilising an innovative approach to fuel demand yet optimise quality of care at all times to it’s clients.
Linda van Dijk, Director Medical Strategy and Development Department, DAMAN, UAE
14.30 Training the Next Generation of Claims Management and Revenue Cycle Management Staff• Understanding the process of RCM in relation to your
role • Improving billing processes• Mitigating fraud• Optimising payments
Mary Shuab, Former Director Revenue Cycle Management, HAAD, UAE
CONSENSUS PANEL15.00 This panel will summarise the Regional Perspective and
reach consensus on a strategy to align moving forward Lina Jichi, Head of Health Financing, Monitoring and
Advisory – Strategy, HAAD, UAE Linda van Dijk, Director Medical Strategy & Development
department, DAMAN, UAE Mary Shuab, Former Director Revenue Cycle Management,
HAAD, UAE Paul Vincke, Managing Director, European Healthcare
Fraud and Corruption Network EHFCN, Belgium Led by: Husam Majali MD, Market Access Lead – Private Insurance
and Pricing, Merck, UAE
15.30 Close of Conference Day 1
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Paul VinckeManaging Director,
European Healthcare Fraud and Corruption Network EHFCN, Belgium
Over the last decades fraud has been ignored as a hidden cost in healthcare. Only with the crisis coming down hard on healthcare budgets, the tone at the top has changed: healthcare fraud has become a business cost that should be reduced.
Tuesday | 28th January 2014CONFERENCE DAY TWO
T: +971 4 335 2437 | F: +971 4 335 2438 | E: [email protected] | W: www.iirme.com/healthcareinsurance T: +971 4 335 2437 | F: +971 4 335 2438 | E: [email protected] | W: www.iirme.com/healthcareinsurance
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8.50 Re-cap of Day 1 and an Overview of the Conference Day 2Dr Finn Goldner, Director, True Codes Consultancy, Germany
PROVIDER RELATIONS9.00 An Institutional Perspective
As an institution and based out of Saudi Arabia does the landscape change? How does it affect delivery of healthcare, versus a private or public provider?Sarry Al Buraik, Advisor to CEO, King Fahad Medical City, KSA
9.15 The Private Hospital Perspective on Working with Insurers
How has the billing landscape changed for private hospitals? Are approvals affecting delivery and quality of care?Jeffery Staples MD, COO, Al Noor Hospital, UAE
9.30 The Public Provider Perspective on Working with InsurersRCM (revenue cycle management) is a contested process by providers and payors. Is it creating hurdles for treatment which was a seamless process in the past? Wayne Keller, Corporate Director, Revenue Cycle Management, SEHA, UAE Invited
9.45 A Regulatory Perspective on working with Insurers How does Qatar see this relationship? Will it step in to streamline processes?Ghazal Siddiqi, Head of Provider Management, Supreme Council of Health, Qatar
10.00 A Positive Role for the TPATPAs are a preferred option. Why can they extend options that payors can’t? What lessons can Insurers learn from them in complimenting their role towards a patient centric model of care?
10.15 Lessons from Germany: Best Practice in Working with Health InsurerFrom a historically preferred centre of excellence this session shares lessons regional insurers could adapt to regional norms and gain ‘preferred’ status – an opportunity for regional excellence! Gerhard Becker, Former Managing Director, University Hospital Dusseldorf, Germany
10.30 Insurance benefits and the impact on QualityCan choosing the right benefits affect healthcare delivery process and generate optimum quality of care? Karen Carbone MD MBA, Group COO Medical Operations, SEHA, UAE
CONSENSUS PANEL10.45 This panel will summarise the Regional Perspective and
reach consensus on a strategy to align moving forwardSarry Al Buraik, Advisor to CEO, King Fahad Medical City, KSA William Pan, Director Revenue Management, Al Noor Hospital, UAEWayne Keller, Corporate Director, Revenue Cycle Management, SEHA, UAE Invited
Ghazal Siddiqi, Head of Provider Management, Supreme Council of Health, Qatar
Gerhard Becker, Former Managing Director, University Hospital Dusseldorf, Germany
Karen Carbone MD MBA, Group COO Medical Operations, SEHA, UAE
Led By: Dr. Saif Al Jaibeji, Vice President, Aetna, UAE
11.15 Coffee and Networking Break
THE BUYER'S PERSPECTIVE11.45 Disease Management and Behaviour Change:
Opportunities and advantages for payors within:• Disease management• Case management• Monitoring healthy behaviour• Incentives for behaviour change• Workplace wellness
Dr Cother Hajat, Adjunct Professor, UAE University, UAE
12.00 If Corporates are customers why can they not gain answers to:• How Health Insurer Premium is calculated• Negotiating the Premium in case of positive
experience• Implementing a Rebate structure in case of lack of
service Imane Alaoui, Benefits Manager, Middle East,
Schlumberger, UAE
12.15 What do Corporates Want? A unique session where representatives from corporates and insurance providers go head to head to debate some of the biggest challenges in the sector • Negotiating an ideal employee insurance plan• Gaining a provider of choice • Options within regional and international coverage• Reducing premiums via tailor-made packages
Safiya Al Matroushi, Director – Human Capital, IMDAAD, UAE
Imane Alaoui, Benefits Manager, Middle East, Schlumberger, UAE
Mansoor Anwer MD, Director, Occupational and Medical Health, du, UAE
Jacclyn Nautiyal, Compensation & Benefits Manager, Europe, Aggreko, Middle East & Africa
Led by Dr Cother Hajat, Adjunct Professor, UAE University, UAE
Insurance Providers will join the panel – By invitation only
12.45 A Guiding Role for Brokers? Brokers are a preferred option. Why can they extend
options that payors can’t? Guardian will share their model which has placed them as a leading broker in the region
13.00 Lunch and Networking Break
14.00 Preparing for the future now Trends within this industry change at a rapid pace. This
session will help you understand what is round the corner and how you could tap into these opportunities.
David T Youssef, CEO, Now Health, UAE
14.15 Cross Product Subsidisation While criticised commonly is there a real need for it in the
first place? Are there advantages we overlook in the long term?
14.30 It’s not just about selling policies! 21st Century Patient Engagement Strategies• How Engaged are you in Patient Outreach?• Analytics to deepen your Patient/ population Insight?• Multi-channel (SMS/ E-mail/ Social media) interactions
with Patients?• The long term benefits of Patient engagement?
Feryal Kazim MD, External Insurance Consultant, UAE
CONSENSUS PANEL14.45 This panel will summarise the Regional Perspective and
reach consensus on a strategy to align moving forward Rasha Moukayed, Manager - Life & Medical, Guardian
Insurance Brokers, UAE David T Youssef, CEO, Now Health, UAE Chris Reed, Head of Corporate Solutions, Middle East,
MetLife Alico, UAE Feryal Kazim MD, External Insurance Consultant, UAE Led By: Husam Majali MD, Market Access Lead – Private Insurance
and Pricing, Merck, UAE
15.15 A summary of discussions and strategy for implementation in the next 6 months
A summary of the day will reach a consensus on how the regional players identify opportunities and decide to move forward. A periodical review via feedback will track progress and initiate regional strategy for 2015.
Dr Finn Goldner, Director, True Codes Consultancy, Germany
15.30 Closing Remarks and Close of Conference
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Registration for each workshop will begin at 08:30. The workshop will commence at 9:00 and end at 14:00 with lunch. There will be breaks at appropriate times.WORSKSHOPS
T: +971 4 335 2437 | F: +971 4 335 2438 | E: [email protected] | W: www.iirme.com/healthcareinsurance
The region’s Healthcare landscape seeks partnerships!
Partnering with the Healthcare Insurance Forum is an extremely effective way for you to share your work as an integral stakeholder within Healthcare’s interoperable and digitally connected platform.
WHY PARTNER? The conference provides a unique, high-profile platform with opportunities to interact with the industry's biggest players and healthcare systems.
The conference will provide tailored and creative partnership packages to suit the organisation, and not just offer an exhibition stand!
ORGANISATIONS CAN:� Meet corporate HR Directors from cross industry sectors
� Broker new business partnerships within a region led by demand
� Showcase innovative cost containment technology
� Position your competition resilient model as futuristic
� Publicise your success via your Healthcare client’s results
� Build brand recognition and raise your integral payor profile
Learn more about how you can support the Healthcare Insurnace Summit by contacting
Renae Ruggieri on+971 (0)4407 2732 or at [email protected]
See more at: www.iirme.com/healthcareInsurance
PARTNER WITH THE HEALTHCARE INSURANCE FORUM
Post-Forum Workshop BWednesday, 29 January 2014
HEALTHCARE FRAUD TYPOLOGYCertified Workshop – This workshop is certified by the European Healthcare Fraud and Corruption Network, Belgium
This workshop will guide delegates on understanding, distinguishing, defining and identifying anomalies and infringement patterns within: healthcare provisions, prescriptions and billing. It will dive deeper into the nature, type and impact in a uniform and standardised format. Distinction will be made between violations of billing rules and non-compliance to guidelines and evidenced based medicine. Effective enforcement strategies will also be presented and discussed. A Fraud Typology Matrix created by EHFCN will be used as an example. Participants will leave mastering the art of implementing case matrix aligned to their area of expertise, discipline and function.
Learning Objectives:• Distinguish and identify anomalies and infringement patterns
in healthcare provisions, prescriptions and billing• Report in a uniform and standardized way on healthcare
fraud issues• Set up and implement effective enforcement strategies to
counter healthcare fraud• Understand the complexity of the nature and origin of
financial losses in healthcare• Identify conditions for preventing and stopping healthcare
fraud
Led by:Paul Vincke, Managing Director, European Healthcare Fraud and Corruption Network EHFCN, Belgium
Paul Vincke is a Director of Staff at the Service of Medical Evaluation and Control (SECM) of the National Institute for Health and Disability Insurance (NIHDI) in Belgium and Managing Director of the European Healthcare Fraud and Corruption Network (EHFCN). He has obtained a degree in Criminology at the Katholieke Universiteit Leuven, Belgium. After having spent 14 years as Financial and Personnel Director at the National Pension fund for Miners, he joined the SECM in 1999 becoming Director of Staff responsible for general management. As a member of the Strategic Management team he has been directly involved in the reorganization of the Service since 2002, aiming at the development of highly efficient systems and tools of screening, prevention, detection and investigation of alleged improper use of the Federal Healthcare Resources by healthcare providers and patients. This resulted in active surveillance of good medical practices and the establishment of appropriate sanctions.
Pre-Forum Workshop ASunday, 26 January 2014
THE OPPORTUNITY FOR CENTERS OF HEALTHCARE EXCELLENCE IN THE MIDDLE EASTCertified Workshop – This workshop is certified by the Medical Tourism Association, USA
Many Insurance Companies have expanded their networks due to rising demand for quality and choice and are allowing their healthcare customers to travel regional and internationally to centers of healthcare excellence. This workshop will explain Medical Tourism (Centers of Excellence) and the growing trend to develop centers of excellence for fixed “bundled/packaged” pricing, and how it lowers costs and increases quality and better outcomes. Understand how to identify centers of excellence, medical procedures that qualify, and which countries to refer consumers too. Learn the emerging trend most insurers are using to differentiate themselves and how to educate and engage your consumers/insured.
Learning Objectives:• How to develop and select a Global Centers of Excellence
Network• How to Develop Bundled Pricing for Packaged Medical
Procedures• The importance of diversifying your network of hospitals• Case Studies of insurers who are successfully implementing this
model• Analysis of Potential Cost Savings
Led by:Renée-Marie Stephano, JD, President, Medical Tourism Association, Chief Editor, Medical Tourism Magazine, USA
President of the Medical Tourism Association®Renee-Marie Stephano is the President and Co-Founder of the Medical Tourism Association and Editor-in-Chief of Medical Tourism Magazine and the Health and Wellness Destination Guide Series of books. Ms. Stephano has authored several books from Developing International Patient centers, Best Practices in Facilitation, to Medical Tourism for Insurers and Employers, and the most recent, Engaging Wellness. Ms. Stephano is an attorney and specializes in working with governments and hospitals to develop sustainable medical tourism/international patient programs and strategies. She has worked with governments and hospitals all over the globe in developing healthcare clusters, international patient departments on long term international patient strategic plans. Ms. Stephano serves on the Board of Directors for the International Healthcare Research Center, a 501c3, nonprofit medical tourism research center, the Corporate Health & Wellness Association, and two Washington D.C. based lobbying groups focused on lobbying the U.S. Congress for the benefits of Medicare reimbursement overseas and the support of U.S. Hospitals in their overseas initiatives.
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26-29 January 2014 • Dusit Thani Hotel, Dubai, UAE
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MD030324 HEALTHCARE INSURANCEJC/SC
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