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Abu Dhabi, UAETuesday 25 September 2018

Expert: sweeping changes to health care in Abu Dhabi bring down the cost of health insurance 

Health insurance costs could also reduce as Health Authority Abu Dhabi bids to improve transparency 

Insurance industry figures said the planned healthcare reforms are a step forward and will eventually help to reduce the cost of health cover.

Last year, insurers said as much as US$1 billion, or Dh3.67bn, was being lost to factors including identity fraud by patients and a culture of over-prescribing by doctors handed financial incentives to prescribe brand-name drugs.

“These changes should hopefully reduce the amount of misuse on medical spend and will hopefully eventually benefit the members themselves,” said Stephen Maclaren, a senior executive at health insurer Al Futtaim Willis.

“The most efficient providers with the best results will be more attractive options for patients, this is a cost containment and it will benefit everyone except the consultants, but something has to give.

“It has to be a transparent system, and ratings are an excellent idea so people can make their own informed healthcare choices."

The competitive enhanced health insurance market has increased to almost 1.46m members, with more than half of the market held by three payers.

Daman has 39.5 per cent of the market, followed by Al Dhafra with 11.9 per cent and Al Hilal with 5.6 per cent. Daman also administers Thiqa and Basic products.

The average number of claims per member has risen from 4.6 in 2009 to 7.1 in 2015, with payers taking about 66 days to remit claims.

It is not uncommon for doctors to split their fees with clinics, creating a culture of unnecessary spending.

“Quality metrics are a good idea and a positive step,” Mr Maclaren added.

“It will give people a lot more trust in their doctors, and they will still be able to go where they want to within their medical network for treatment.

“It will come down to freedom of choice.”

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