Dubai: New health insurance scheme announced for faster claim approvals

Dubai’s health insurance regulator has launched a first-of-its-kind value-based healthcare model. Called Ejadah, the model is expected to enhance preventive care by focussing on value rather than volume.

The Dubai Health Authority’s (DHA’s) Health Insurance Corporation said the healthcare model will pay for performance and outcomes “that matter to patients”. It will also provide healthcare service providers with “evidence-based guidelines which will be a framework for all physicians to follow with regard to treatment protocols for all ailments”.

DHA’s Director-General Awadh Seghayer Al Ketbi said insurance providers will have a “strong foundation” to refer to evidence-based data and “all stakeholders will work together to enhance healthcare and reduce unnecessary medical expenditure”.

Saleh Al Hashimi, CEO of Dubai Health Insurance Corporation, said: “The initiative will help improve government oversight of the health sector by overseeing clinical, economic and human-centric outcomes. The model is driven by quality outcomes, it will put health consumers at the centre of the model, focus on preventive care and reduce healthcare expenditure, thus leading to healthcare sustainability.”

He added that payers and providers will undergo training to understand the framework which will lead to faster claim approvals, minimise waste of healthcare expenditure and focus on preventive care.

Dr Mohamed Farghaly, lead of the Ejadah project at the DHA, explained how a significant part of the cost of managing non-communicable diseases such as diabetes actually goes towards managing the complications of the disease rather than the disease itself.

“By implementing an ecosystem that focuses on preventive care and patient-centered care, this cost can be significantly reduced,” said Dr Farghaly, who is also Family Medicine Consultant, Diabetologist and Professor of Medicine at the Dubai Medical College.

He added that the model will empower patients.

Karim Samy, Medical Director and Personalised Healthcare Lead of Roche Pharmaceuticals for the UAE, said: “Ejadah will work towards ensuring that Dubai’s healthcare sector becomes more sustainable and patient-centric going forward, with incentivising improvements in value – rather than volume – through alternative payment models. It will no doubt also pave the way and inspire other territories in the region to consider similar approaches.”

Ahmed Fadl, GM Merck Gulf, said the project aims to increase efficiency, efficacy, and safety. “The Ejadah programme improvements will further increase the quality and address the costs while allowing access to next-generation technology.”


Khaleej Times

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