6 Dec 2016
DHA adopts new health insurance payment system that will improve transparency and quality of healthcare
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The Dubai Health Authority (DHA) announced that it will be adopting a new health insurance payment system that will improve transparency and quality of healthcare services in the emirate of Dubai.
His Excellency Humaid Al Qatami, Chairman of the Board and Director General of DHA announced that the executive council has approved the implementation of International Refined Diagnosis-Related Group (IR DRG) under resolution No. 21 of 2016 in line with the launch of the third and last phase of the health insurance system ‘Isahd’ (Happiness).
Payment by this new system will simplify the payment process, encourages administrative efficiency, and basis payments on patient acuity and hospital resources rather than length of stay.
Al Qatami said this step is important to develop health services in Dubai as adopting such a clear pricing method allows hospitals and clinics to provide fair prices it also allows for investment opportunities based on set standards. He added that the executive council decided to adopt the new system after holding a series of meetings with insurance provides and after studying its benefits for two years and benchmarking with best international practices.
Dr Haidar Al Yousef, Director of the Health Funding at DHA said the new system also adopts a a statistical system of classifying any inpatient stay into groups for the purposes of payment. The DRG classification system divides possible diagnoses for the purpose of reimbursement with built in incentives for higher quality providers.
It also has a medical inflation indicator that caters to increases in cost for the medical sector in collaboration with the Dubai Statistic Center, which can produce indicators of inflation particular to health.
Dr Haidar said the new system will be implemented within three years starting 2017 and ending in 2019, in order for the hospitals and clinics to adopt the new system under Esaad seamlessly.
The pilot phase with shadow billing will begin in 2017 for hospital accommodation only, and will last till the end of 2017.
At the beginning of 2018, all services will be included and the pilot phase for outpatient clinics will began, so that in 2019 the system will be implemented in full effect.
Dr Al Yousuf said the system was chosen after an number of evaluations, which proved that it can use the authority’s unified data system.
DHA organized a workshop yesterday in partnership with all the concerned parties and strategic partners to familiarize them with the new payment system.
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