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#HealthcareInsuranceME
26-29 January 2014 • Dusit Thani Hotel, Dubai, UAE
The Customer Experience
FORUM HIGHLIGHTS
EXPERT SPEAKER FACULTY
Gain a 360 degree perspective: Payer - Provider - Buyer - Corporates Relate Insurance payouts to wellness and population health
David T Youssef CEO Now Health UAE
Dr Cother Hajat Adjunct Professor UAE University UAE
Dr Sven Rohte Chief Commercial Officer DAMAN UAE
Feryal Kazim MD External Insurance Consultant UAE
Gerhard Becker Former Managing Director University Hospital Dusseldorf Germany
Husam Majali MD Market Access Lead – Private Insurance and Pricing Merck UAE
Husein Reka Manager Health Insurance, Supreme Council of Health Qatar
Imane Alaoui Benefits Manager, Middle East, Schlumberger UAE
Karen Carbone MD MBA Group COO Medical Operations SEHA UAE
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…
WHAT’S NEW FOR THIS YEAR? î The corporate perspective î Improving provider relationships î Addressing population health and wellness
Linda van Dijk Director Medical Strategy & Development department DAMAN UAE
î MENA compatibility within policies î Niche opportunities in a competitive market î Accelerate ROI via cost containment î Workshops
Paul Vincke Managing Director, European Healthcare Fraud and Corruption Network EHFCN, Belgium
•
Ghazal Siddiqi, Head of Provider Management, Supreme Council of Health, Qatar
• Disease Management
•
Mary Shuab, Former Director Revenue Cycle Management, HAAD, UAE
• Medical Tourism - Centers of Healthcare Excellence
•
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
• Coding • Healthcare Fraud Typology
and many more…
Organised By
www.iirme.com/healthcareinsurance
Dear Insurance Executive,
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. Kind regards,
Sally Corander Divisional Manager
EXPERT SPEAKER FACULTY CONFERENCE CHAIR:
KEYNOTES:
Dr Finn Goldner, Director, True Codes Consultancy, Germany
Dr Cother Hajat, Adjunct Professor, UAE University, UAE
WORKSHOP LEADERS:
Dr Mansoor Anwer, Director, Occupational and Medical Health, du, UAE
Paul Vincke, Managing Director, European Healthcare Fraud and Corruption Network EHFCN, Belgium
Dr Saif Al Jaibeji, Vice President, Aetna, UAE
Renée-Marie Stephano, JD, President, Medical Tourism Association, Chief Editor, Medical Tourism Magazine, USA
Imane Alaoui, Benefits Manager, Middle East, Schlumberger, UAE
MODERATORS:
Paul Vincke, Managing Director, European Healthcare Fraud and Corruption Network EHFCN, Belgium
Dr Cother Hajat, Adjunct Professor, UAE University, UAE
Dr Sven Rohte, Chief Commercial Officer, DAMAN, UAE
Dr Saif Al Jaibeji, Vice President, Aetna, UAE
Renée-Marie Stephano, JD, President, Medical Tourism Association, Chief Editor, Medical Tourism Magazine, USA
Husam Majali MD, Market Access Lead – Private Insurance and Pricing, Merck, UAE
Sarry Al Buraik, Advisor to CEO, King Fahad Medical City, KSA
Dr Finn Goldner, Director, True Codes Consultancy, Germany
Networking Activities More networking than ever before to ensure better interaction and shared learning
ONE ON ONE
Meet 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.
T: +971 4 335 2437 | F: +971 4 335 2438 | E: register@iirme.com | W: www.iirme.com/healthcareinsurance
CONFERENCE DAY ONE
OPENING KEYNOTE
OPPORTUNITIES
KEYNOTE
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
KEYNOTE
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
KEYNOTE
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 PERSPECTIVE 10.00 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. 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 PANEL 11.30 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 Led by: Dr Finn Goldner, Director, True Codes Consultancy, Germany
KEYNOTE
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
COST CONTAINMENT 12.00 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 KEYNOTE
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
Monday | 27th January 2014
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 PANEL 15.00 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
Paul Vincke Managing 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.
T: +971 4 335 2437 | F: +971 4 335 2438 | E: register@iirme.com | W: www.iirme.com/healthcareinsurance
CONFERENCE DAY TWO PROVIDER RELATIONS KEYNOTE
9.00 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 Insurers RCM (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 TPA TPAs 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 Insurer From 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 Quality Can 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 PANEL 10.45 This panel will summarise the Regional Perspective and reach consensus on a strategy to align moving forward Sarry Al Buraik, Advisor to CEO, King Fahad Medical City, KSA William Pan, Director Revenue Management, Al Noor Hospital, UAE Wayne 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 PERSPECTIVE
KEYNOTE
11.45 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 PANEL DISCUSSION
8.50 Re-cap of Day 1 and an Overview of the Conference Day 2 Dr Finn Goldner, Director, True Codes Consultancy, Germany
Tuesday | 28th January 2014
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 PANEL 14.45 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
T: +971 4 335 2437 | F: +971 4 335 2438 | E: register@iirme.com | W: www.iirme.com/healthcareinsurance
PARTNER WITH THE HEALTHCARE INSURANCE FORUM 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.
ORGANISATIONS CAN: î Meet corporate HR Directors from cross industry sectors î Broker new business partnerships within a region led by demand î Showcase innovative cost containment technology î Position your competition resilient model as futuristic î Publicise your success via your Healthcare client’s results î 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 sponsorship@iirme.com See more at: www.iirme.com/healthcareInsurance
The conference will provide tailored and creative partnership packages to suit the organisation, and not just offer an exhibition stand!
WORSKSHOPS
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.
Pre-Forum Workshop A
Post-Forum Workshop B
Sunday, 26 January 2014
Wednesday, 29 January 2014
THE OPPORTUNITY FOR CENTERS OF HEALTHCARE EXCELLENCE IN THE MIDDLE EAST
HEALTHCARE FRAUD TYPOLOGY
Certified 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.
Certified 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 noncompliance 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:
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.
• • • •
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.
T: +971 4 335 2437 | F: +971 4 335 2438 | E: register@iirme.com | W: www.iirme.com/healthcareinsurance
26-29 January 2014 • Dusit Thani Hotel, Dubai, UAE
Five Easy Ways To Register +971 4 335 2437
+971 4 335 2438
register@iirme.com
IIR Holdings Ltd. P.O Box 9428, Dubai, UAE
www.iirme.com/healthcareinsurance
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PLEASE þ THE SESSION/S YOU WISH TO ATTEND: SUPER EARLY BIRD SAVER! Register before 28 November 2013
GROUP DISCOUNTS AVAILABLE EARLY BIRD Price before 29 December 2013
Standard Price Price after 29 December 2013
¨ Conference + 2 Workshop Days
US$ 2,495
US$ 2,695
US$ 2,895
¨ Conference + 1 Workshop Day
US$ 2,195
US$ 2,395
US$ 2,595
¨ Conference Only
US$ 1,795
US$ 1,995
US$ 2,095
¨ Workshop Day only
US$ 695
US$ 795
US$ 895
CALL: +971 4 335 2483 E-MAIL: a.watts@iirme.com Conference fees include documentation, luncheon and refreshments. Delegates who attend all sessions will receive a Certificate of Attendance by email.
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CANCELLATION
ACCOMMODATION DETAILS
If you are unable to attend, a substitute delegate will be welcome in your place. Registrations cancelled more than 7 days before the Event are subject to a $200 administration charge. Registration fees for registrations cancelled 7 days or less before the Event must be paid in full. Substitutions are welcome at any time.
We highly recommend you secure your room reservation at the earliest to avoid last minute inconvenience. You can contact the IIR Hospitality Desk for assistance on: Tel: +971 4 407 2693 Fax: +971 4 407 2517 Email: hospitality@iirme.com
All registrations are subject to acceptance by IIR which will be confirmed to you in writing. Due to unforeseen circumstances, the programme may change and IIR reserves the right to alter the venue and/or speakers or topics.
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HEALTHCARE INSURANCE
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