Download - Profile presentation to KHAC
Corporate ProfileJuly 2013
About Warba Insurance Kuwait Shareholding Company incorporated in 1976. The fastest growing general insurance provider in Kuwait.
Listed on Kuwait Stock Exchange since 1983; Stock Code: WINS
Capital of KD 17.4/- million. (USD 62 Million)
S&P Rating : BBB - June 2013
Operating with the support of a wide network of branches & partners located in Kuwait & across the globe
Table of contentsI. Company profile and strategyII. Affiliates & AssociatesIII. Clinical Health ManagementIV. WAPMEDV. ApolloVI. AetnaVII. Q&A
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Warba Insurance CoCorporate Profile
and Strategy
Vision & Mission Visionan organization that formulates and implements effective policy, provides
timely and accurate insurance solutions, and is capable of providing a modern, interoperable, sustainable model that can exceed customer expectation whilst maintaining conservative underwriting of risk
Missionto provide effective insurance and risk management solutions that meet the
evolving needs of the clients.
Strong sustainable operations
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Over the past few years, WIC has strengthened its position in its home market.
Earnings growth has been satisfactorily high, driven by strong cash flows, intensive underwriting activities and an underleveraged consumer base.
Financial track record
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WIC has delivered well on its financial targets and is committed to improve its performance levels further whilst maintaining a conservative risk culture and solid solvency levels.
Collected insurance premiums on a comparable basis up 2.5% to 26 M from 25 M (mainly unit-linked life)
Strong business volume growth across our activities / geographic areas, generating strong commission income and offsetting impact of flattened yield curve
Gross Premiums
Shareholder Equity
Financial track record
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Profit from marking-to-markets and realised capital gains on investments signifcantly higher than 2011
Very low credit-risk provisioning (loss ratio: 0.01%) / no net impairments on the investment portfolio
Sustained sound non-life underwriting performance (combined ratio: 4%)
Technical Reserves
Gross Profit
2013 at a glance - business developments
Strengthening of long-term strategy
New group management structure along business lines (start: Mar -13)
Share buy-back programme Enhancement of both cross-selling
and cost-savings projects Overseas expansion to further
strengthen the operations
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Streamlining of corporate identities of operations (use of WIC CI)
Integration of asset management and investment activities
Renewal of the long-term strategic distribution/associative agreements
Decision to open new branches (organic growth)
Associates
Partners in successPakistan’s largest insurance provider.Serve: 9M clients globally 6k in Kuwait
India’s largest insurance & investment groupServe: 100M clients globally 8k in Kuwait
Middle East’s largest extended warranty providerServe: 4M clients regionally 140k in KuwaitKuwait’s largest passport & visa processer serving Indian & Saudi embassiesServe: 230k clients in Kuwait
Northern Europe’s largest private healthcare companyServe: 10M clients globally 11k in KuwaitWorld’s leading int’l health insurer for expatsServe: 15M clients globally 16k in Kuwait
US’s 2nd largest health care management organizationServe: 65M clients globally 24k in Kuwait
Kuwait’s leading third party medical services administratorServe: 22M clients globally 80k in KuwaitPrivate Healthcare provider with 9000 hospitals.Serve: 1.3M patients annually
India’s largest housing finance groupServe: 50M clients globally 6k in Kuwait
WAPMEDGlobal Quality TPA Services
within your grasp
WAPMED WAPMED is a Joint Venture between Bukhamseen Group (Kuwait) which is a very reputed business
group in GCC and Family Health Plan Ltd (Apollo Hospitals Group – India) First Licensed Third Party Administrator (TPA) established under the laws of Kuwait. Operated by qualified, well experienced leaders in the field of health insurance TPA services Offers a complete suite of healthcare services complementing health care plans Casts wider spectrum of coverage of health care benefits for members and families Administers medical benefits for organizations groups Liaison with insurance companies to best design the product suit that fits client needs
Worldwide Service Footprint
Over 6000 Network Providers Spread Across 33+ Countries & 5 Continents & Growing…
Full Cycle Administration Coverage Customization Insurance provider liaising Enrollment & ID dispensing Creation of Universal Health Identification
UHID Access to health network providers Telephonic Help Desk information resources
and services Personalized Client Services Managed Care Information System for efficacy
of health plans for all stakeholders Case Management Services to monitor quality
of deliverable.
Client OrientedDiscounts on Services through aptly negotiated Tariffs across the globe
•Statistical Cost Tracking•Negotiated MoU Tariffs•Strict risk assessment techniques
•24 Hrs Call Centre•Dedicated Helpline•Personalized services•Email services •24 x 7 assistance
•Health Talk Shows•Educational Mailers•Health Checkup Camps•Completely Personalized Health Assistance Services
M-Care application tested for managing over 22 million lives
Capable of handling e-claims & capturing ICD, CPT & PCS codes (Master driven)
Thoroughly tested platform over 12 yrs Exposed to handle variety of policies
from international market especially Middle-East
Service Modules customized & designed to cater policies providing Out Patient (OP) coverage
Supports both single currency & multi-currency platforms to cater local & international policies
Claims Processing
FHPL – Family Health Plan Limited Main backer of WAPMED Subsidiary of Apollo Group of Hospitals Licensed TPA with decades old experience in Indian Health Insurance Only ISO & CRISIL Certified TPA in India Offering service to over 70 million through network of 4500 hospitals Only TPA to design and implement HMO in India
ApolloTouching Lives
Apollo 54 Locations 9000 beds 65000 employees Touched 32 million lives 7 million Preventive Health Checks Patients from 120 countries 1,30,000 Cardiothoracic Surgeries Over 10000 Joint Replacements First Liver Transplant in Children and Adults & First Multi Organ Transplant Over 8400 Kidney Transplants Over 500 Bone Marrow and 1165 Liver Transplants
An integrated healthcare enterprise
Specialties:Heart • Orthopedics • Spine • Cancer Care • Gastroenterology • Neurosciences • Nephrology & Urology • Critical Care • Preventive Health Alliances :AIG International Group • American Life Insurance Company • Vanbreda • International SOS • Seven Corners • Companion Global Health • Emergency Assistance Japan • GMC Services • International Claims Service • Prestige International
Apollo Innovation Apollo Innovation and and
Quality AwardsQuality Awards
Hospital services
Clinical services
HR practices
Community service Environmental conservation
Financial management
Full Cycle Clinical Service
Worldwide Footprint in all Medical fields
AetnaBetter Health Today
World leading global diversified health benefits company. Serves approximately 44 million people with information and resources . Broad range of traditional /consumer-directed health insurance products and related
services, including : Medical • Pharmacy • Dental • Behavioral health • Long-term care • Disability plans Medical management capabilities and health care management services. Committed to helping create a stronger, healthier global community by delivering effective
health management solutions worldwide. Health Management business collaborates with health care systems, government entities
and plan sponsors worldwide. Recently appointed by the National Health Insurance Company (NHIC) of Qatar to support
development of its capabilities for clinical case management, disease management and advanced analytic reporting.
Aetna
Total Population Health Management
• Cardiac Rehab.• Physical Therapy• Maternity Management
• Exercise• Healthy Eating• Stress Management• Nutrition Counseling
• Metabolic Syndrome • Weight Management• EAP• Smoking Cessation• Back Health
• Disease Management • Behavioral Health• Wellness Coaching
Improving Health and Reducing Risk
Health/low riskAt risk fordisease/injury Managing
a chronicdisease Major health
events
16% per year23% per year Natural Risk Migration
(avoid risk save $$$$) (reduce risk save $$$)
Global Footprint
Core Business OperationsComplianceNetworkSupport Services
Claims ProcessingMultiple LanguagesMultiple Currencies24/ 7 working consultants
Health Care ManagementGov’t administrative servicesGov’t financial servicesGov’t value added servicesMember Services30 Languages24/7/365Professional CSR service
Dedicated Plan Sponsor ServicesPlan Setup & ImplementationBillingOngoing account maintenance
Medical DirectorsBusiness StrategiesInternational StandardsMedical Care Delivery
Fully Integrated Clinical SolutionRoot CausesHealthcare System Problems
Data Fragmentation Historical claims and non-claims data
reside in multiple non-integrated sources
Knowledge/Care Delivery Gaps The lag between the discovery of more
effective forms of treatment and their incorporation into routine patient care averages 17 years
Lifestyle Decisions Unhealthy behaviors lead to increased
health risk, adverse events and cost
Care Team Communication Gaps Patients and their provider(s) typically
make decisions with incomplete information leading to sub-optimal coordinated care
Between 44,000–98,000 people die in hospitals each year as a result of preventable medical errors.
Medical errors for hospitalized patients cost roughly $2 billion annually.
More than 50% of patients with diabetes, hypertension, tobacco addiction, hyperlipidemia, CHF, asthma, depression and chronic atrial fibrillation are currently managed inadequately.
More than 70% of cancers, heart disease, stroke and diabetes are caused by poor lifestyle.
Key Tenets
Actively facilitate patient, provider and Aetna relationship to improve health care quality and lower total costs
Meet providers and members where they are, at natural points of interaction
Apply evidence base into everything we do, to influence the way care is accessed and delivered through our networks and programs
Deliver relevant information and decision support to members and providers to facilitate improved quality and cost effective health care decisions
Reduce provider complexity and improve transparency through information sharing and innovative payment models
Enable and incentivize members to drive sustainable healthy behaviors
Healthcare
Provider
Plan
Member
Network Enhancements
Health & Wellness
Informatics
Plan Design & Incentives
Provider Payments
Health Information Technology
Aetna’s Clinical Strategy: “Quality and Total Cost”
Clinical HealthManagement
A Persistent Search for ValueKey Players: Wide Variation in Scope, Degree of Integration, & Geographic Context
Health plans – wide array of benefits and variation in provider network scope
Physicians – solo practice, single specialty groups, multi-specialty groups, groups linked with hospitals, core of integrated healthcare Hospitals – individual and system members; various ownership structures
Pharmaceuticals – similar to manufacturers
In contrast w/ other components, no local barriers exist Not addressed, for the most part
Full integration: Hospitals, MDs, and Insurance in one package:
Warba has 3 components available locally and a common incentive structure
Partial integration: Physician/Hospital alliances
Non integrated. Most common, insurers contract with all health care providers
Provider Integration Health Plans – national, regional &
internationalo Consumer directed – national
players
Physician Groups – mostly local, some regionalo Multiple and single specialty local
groups
Hospitals – mostly local and regionalo Local and regional systems are
commonplace Many have a business group
orientation Tertiary component in
regional systems
Geographic Orientation
Healthcare Expenditure: Recent Facts HC (KD) = (price/service) x (services/person) x (people served)
1990 – 2010 growth accounting breakdown – 33% - general inflation– 22% - medical price rises above inflation rate– 16% - population/ demographic change– 29% - intensity of service
Growth in inflation-adjusted HC (KD) per person driven by new technology and services per person
– Average - 3.6% per year since 2001 but not smooth
Not Unique to the GCC (1990 -2010)– Kuwait HC (KD) growth = GDP growth + 2.7% – Other GCC countries HC (KD) growth = GDP growth + 2.0%
Contracts & Risk Sharing Labor/Management Contract: Firm manages health benefits or shifts
burden to employees Company/Health Plan Contracts: Health plan defines benefit plan
design/scope as well as provider network breadth
Provider/Health Plan Contracts: – Prepaid (capitation or salary) or Fee-for-Service– Fee schedules, discounts, and payment tiers are commonplace
RX/Health Plan: tiers (typically 3), formularies, & discounts– Few plans relate to value or benefit of intervention– Variety of incentives for rebates and substitution
Direct Contract: Skip health plan but not risk bearing
Good Contracts lead to1. Good RelationshipsYou get what you pay for :
More choice of provider, costs more
If procedures are rewarded, pay twice for errors
Improved outcomes (pay for performance)
Short term incentives differ from long term ones
Coverage of primary and secondary prevention
Payment related to place of service and accesso ambulatory versus inpatient
coverageo ER coverage vs. clinic (timely
access? 24/7)
2. Cost ContainmentTarget/control specific health care componentsSeek increased efficiency of the delivery system (supply management)Emphasize primary and secondary preventionProvide financial incentives for patients to reduce their use of medical services (demand management)Implement administrative controls on the use of servicesIncrease bargaining power by joining purchasing coalitions
Total National Health Management Solution
Questions?
Thank you