MARM_MCC_ANWB_07052015

www.marmassistance.com© 2015 marmassistance. All Rights Reserved.

1

Global Network

30 years of Experience

Tailor Made Solutions

24/7 Assistance

all-in-one solution

Medical Cost Containment in Turkey

Risks and Solutions

2015


2

Marmassistance Intro and Cost Containment ConceptsTurkish Healthcare System

Public Healthcare System RisksPrivate Healthcare System Risks

SolutionsBenefits of a Local Partner

Information TechnologyConclusion

Contents


3

• Pioneer and leading assistance company in Turkey• Nearly 30 years of experience in medical, roadside, travel and legal

assistance services• State-of-the-art 24/7 multi-lingual Alarm Centre• In-house team of full-time doctors and specialised personnel• ISO 9001:2002 which has been renewed every two years• ISO 27001:2013 Information Security Management System• ITIC Cost Containment Company of the Year Award Finalist (2010, 2012)• ITIC Cost Containment Company of the Year Award 2013

About UsLeading Assistance Provider in Turkey and the Middle East

4


• Turkey• Middle East: Iran, Iraq, Jordan, Israel, Lebanon, S.Arabia, Kuwait, Bahrain , Qatar, Oman, The UAE, Yemen.• North Africa: Egypt, Libya.• Eurasia: Azerbaijan, Georgia, Armenia, Greece, Bulgaria, Cyprus, • Asia: Turkmenistan, Kazakhstan, Tajikistan, Pakistan, Afghanistan, India, Bangladesh

Service NetworkAssisting Globally

5


02

HospitalAgreements

03

Evidence Based

Medicine

04

Policy Matching

Local Legislations

01

IndustryBenchmarki

ng

06

Financial Review

05

Cost Containment Concepts6 Step Structure

6


CPost-DischargeRE-PRICING

BAdmissionEVALUATION & BILL ANALYSIS

A Pre-AdmissionLEAD PRICING

Maximal

Minimal

CCEffectivenes

s

Cost Containment ConceptsApproach

7


• Centralised governance• Health Transformation Programme, in effect since 2003, has

dramatically expanded healthcare infrastructure• 2011 health financing breakdown:

72.7% public sources19.2% private out-of-pocket payments8.1% corporations other than health insurance

• Health staff have a quantitative performance-based salary component (average 52% of the salary)

Turkish Public Healthcare System

Hospital Type Foreign Patients (2012) Total Income (Euro) Average Income/PatientPublic 22,491 32% 44,982,000 2000

8


• Represents 36% of hospitals and nearly 18% of all hospital beds• Hospitals receive a flat fee/patient from the Social Security Institution• Facilities are free to charge additional costs up to a maximum of 90%

more than the public hospital price• 50 JCI accredited hospitals, foreign patient influx main incentive

Turkish Private Healthcare System

Hospital Type Foreign Patients (2012) Total Income (Euro) Average Income/PatientPrivate 47,972 68% 145,172,000 3026

9


• Significant increase in foreign patient prices since 2012 (2 fold to up to 10 fold for certain items)

• Being run as business models• Pushes private hospitals to inflate prices as well• Emphasis on high productivity pushes costs up, with no improvement in

quality • Cost Collection Agencies taking advantage of lower public hospital and

2nd rate private hospital prices to make inflated invoices • Chief Physicians are more actively involved in business rather than

clinical matters• Ministry of Health monitors revenues and intervenes accordingly• Increasing awareness of foreign patients’ revenue potential

Risks in Public Health Sector

10


• Monopolistic mergers and acquisitions by the major hospital groups • Free market system with no price limits• Late notifications by primary insurers to local partners (post admission –

post discharge stages)• Each hospital handling foreign patients can have 3 to 7 price lists as per tourist origin:

1. Arab2. US3. European4. Turkish Citizen5. Russian6. Local Private Medical Insurance Company Insured7. SGK + Turkish Citizen

Risks in Private Health Sector

11


• Clinics operating seasonally are compelled to gross a year’s income within 6 months

• Inflates prices of other hospitals

January February March April May June July August September October November December0

5000

10000

15000

20000

25000

30000

35000

40000

45000

50000

Tourist vs Tourist Patients Monthly Trends

Tourists x 100 Tourist Patients


12


• Fierce competition for the latest technology between hospitals leading to higher investments and price inflation

• Hospitals target IPMIS and Assistance Companies for investment returns• Non-medical background management/ownership• Pharmaceutical companies influences• Chain of Beneficiaries: Taxies - Hotels – Tour Operators – Ambulance

providers – Hospitals – Clinics


13


• Discount agreements with the hospitals• Strict adherence to local pricing standards when reviewing bills• Clinically sound medical doctors cross matching medical reports with

charged services• Monitoring for unnecessary or uncovered interventions throughout the

hospitalisation• Pre-admission notification by the primary insurer facilitates patient

referral to reasonably priced high quality hospitals

Solutions

14


• Detailed, updated knowledge about price rates, number of lists and policies

• Retrospective cost negotiation/reduction facility• Consistent cost containment approach towards the hospitals• Cheapest possible implementation of local pricing standards (TTB)• Auditing to identify consistently over-charging, fraudulent

hospitals for primary insurers and the MoH• Assistance partners with strong mutual support

Solutions

15


• Better understanding of local market dynamics• On spot monitoring and investigations• Improved management capability of local pricing• Local cultural familiarity• Reliability of the service providers• Reputation• Period of existence• Technological edge

Benefits of a Local Partner

16


In-House Technology and R&D Team24/7 Availability and SupportRemote Management and MaintenanceIP, PSTN, GSM and Satellite Communication SystemsBusiness Continuity and DR ReadinessIn-House Developed ERP SoftwareMarmNet – Realtime Collaboration ToolTransparent and Evidence Based ReportingGlobally Accepted and Certified Processes

30 years of Big Data Analysis for Best ResultTailor Made Solutions

InformationTechnologiesWhat We Provide Through Increased Productivity

17


• In-house developed MarmNET -Online File Handling System- lets your operations department handle big volumes of files with total ease, control and transparency.

• MarmNET allows you to monitor all your medical files handled by us through a one-stop website.

• You will easily find any specific file you’re looking for, see at what stage that file is, view all documents associated with that file.

• What’s more, you will be able to find a general overview of your annual operations through enlightening statistics along with delicate and confidential financial reports.

RealtimeCollaboration

Online CaseTracking

ComprehensiveStatistics

TransparentReporting

MarmNetTransparent and Evidence Based Reporting


Next generation mobile application using “Personalized Mobility and Cloud Communication” platform. Application is compatible with IOS and Android devices.

Realtime Collaboration via Video, Voice and TextCustomizable ArchitectureHardware Independent

Roadside Assistanc

e

Information

Services

24/7 Alarm Center

Emergency

Assistance

Time and Cost Saving

Mobile AppLet Us Assist You Anytime Anywhere

19


• The exponential expansion of the Turkish Healthcare System over the last decade has had a direct impact on costs

• High investments in infrastructure, technology and accreditations has resulted in a high profit orientation

• An established, scientific and consistent professional approach is needed to counter the inflating prices

• Effective and timely support from the primary insurer is also vital for maximising the cost containment outcomes

Conclusion

20


AddressGrup Center Is Merkezi Mustafa Akyol Sokak No:158 Yenisehir Kurtköy, Pendik 34912 Istanbul / Turkey

Social Mediafacebook.com/marmassistancetwitter.com/marmassistanceinstagram.com/marmassistancepinterest.com/marmassistance/linkedin.com/company/marm-assistance

Thank You

+90 216 560 07 24+90 216 560 07 [email protected]

Contact Us

MARM_MCC_ANWB_07052015

Documents

Transcript of MARM_MCC_ANWB_07052015