How is Qatar a pillar in GlobeMed's activities across the Middle East and Africa?
GlobeMed was among the first TPAs to operate in the region. We started operations in Lebanon early in 1991; since the beginning, we set bold expansion plans targeting first the GCC region, and eying Qatar in particular. We saw huge potentials for growth in the Qatari health insurance sector particularly that Qatar's healthcare spending is among the highest in the Middle East, and the country has an excellent and well-developed healthcare infrastructure. Furthermore, Qatar has become a hub for major businesses and operations in the Middle East, therefore it was essential for us to be part of the Qatari health insurance market. Consequently, in 2007 GlobeMed Qatar was established and obtained its TPA license from the Qatar Financial Centre Authority. We started off small, but now GlobeMed is proudly serving a large portfolio of insured members.
What has been the impact of the introduction of the Third Party Administrator (TPA) model to the Middle Eastern market?
As health insurance sector started growing in the Middle Eastern market, there was a need for a strong and robust entity to support this growth. Hence, the introduction of the TPA was inevitable. As I mentioned earlier, we were pioneers, being the first TPA in the Middle East back in 1991 when this concept was still new to the market. At that time, most of the functions that a TPA does were being handled by the insurance companies themselves. However, with the changing dynamics in a highly competitive market, there was a strong need for a TPA which serves as efficient back-office assisting healthcare payers in providing quality service and allowing them to redirect their focus to the revenue driven processes instead of handling the cost center functions. As a TPA, GlobeMed's role evolved from the traditional claims processing to managing healthcare benefits. Our solutions provide healthcare payers with the necessary balance between cost containment and quality of service; this is what made us stand out from other TPAs in the market. Automation is at the core of our work; and today we have managed to automate 80% of approvals, thus the patient has faster access to the required medical service while the potential for human error is significantly decreased. Supported by our ARC (Actionable Rules Control) rules engine, our solution enhances the claims processing accuracy, and helps accelerate payments to healthcare providers and members. Furthermore, when it comes to healthcare, wellness is the top trend these days and at GlobeMed, we now put more emphasis on wellness care thus moving from sick care to more well care. Accordingly, individuals can achieve a better quality of life through healthy lifestyles based on informed choices and healthcare payers will be able to better manage the increasing cost of healthcare.
How does GlobeMed Qatar plan to capitalize on the opportunities the new health insurance scheme will open up for the insurance market?
Our portfolio of private health insurance companies has been growing steadily ever since we got our license to operate in Qatar by the Qatar Financial Centre Authority in 2007, and which currently consists of around 100,000 insured members which is considerable for a relatively small market. After the government has decided to shift the previous national health insurance scheme for Qataris to the private sector, we are yet to hear any official news about the business model and the anticipated dates. Nevertheless, and after our experience in Qatar for the last 10 years, we are currently ready to cater for such a large size of insured population at both technical/system readiness side as well as the know-how and expertise side. From the technical point of view, our system is highly scalable thus capable of handling great amounts of load efficiently. It is optimized to deliver high performance while accommodating a growing insurance portfolio.
How do you assess the value of your pharmacy benefit manager (PBM) solutions to improve the pharmacy's benefits plans?
The PBM is one of the valuable tools that GlobeMed offers and it has become a must now in the medical insurance sector. Our PBM is a state-of-the-art pre-authorization & adjudication platform with advanced clinical programs including generic substitutions, step therapy, chronic medications management, and other programs to control costs for both acute and chronic prescriptions and to ensure high quality of care. The solution helps healthcare payers to manage and analyze costs and utilization for their prescription benefits program. At the heart of the solution, lies a set of pre-designed rules, ARC, which checks new and refill prescriptions for indications and contraindications, alerts for therapy duplication, medication overuse, and various forms of drug interactions. ARC rules are based on algorithms with a dedicated committee of pharmacists working on updating them continuously.
How do you assess the potential of the takaful insurance segment in Qatar?
Takaful insurance has been growing exponentially for the past couple of years and there is still room for further growth. This is particularly the case of Qatar, because there are many employers that consider themselves takaful entities even if these are not financial institutions. At the end of the day, these companies will require insurance coverage. The central bank has been drawing some guidelines to create a framework for these companies. Now, conventional insurance companies, which want to sell takaful policies, have to get a specific license and set up a separate entity. GlobeMed Qatar is servicing both conventional and takaful companies. Despite that we have grown our portfolio exponentially during our 10 years of operations in Qatar, where insurance penetration is still on the low side, there is obviously room for further growth and greater penetration in the market, specifically in the medical insurance segment. I would say that lack of awareness is one of the factors leading the slow penetration in this market, and this is why GlobeMed Qatar is constantly trying to find ways in collaboration with its client insurance companies as well as with various stakeholders to increase awareness on the health insurance need in Qatar.
What is your outlook for 2017?
The economic forecast in the region and in particular in Qatar has been unfavorable and challenging since 2016. We have witnessed the impact of this in the insurance market. Despite the challenges, we were able to sustain our steady growth and we expect this to continue. By the fourth quarter of 2017, we anticipate to see some positive indicators in the Qatari market. GlobeMed Qatar is doing well and we expect this performance to continue during 2017. This is a year of preparation as we anticipate a lot of growth coming up and we want to make sure we are ready to provide the best services possible to our clients and to the population of Qatar.