IMPROVEMENTS ACROSS THE BOARD

Saudi Arabia 2020 | HEALTH | INTERVIEW

CCHI seeks to be a pioneer in enhancing the quality of health services in the Kingdom by raising the efficiency of private health insurance.

Dr. Shabab Alghamdi
BIOGRAPHY

Dr. Shabab Alghamdi was appointed Secretary General of CCHI in 2019. He joined the organization from the Ministry of Health, where he earlier established and headed the medical services purchasing department. While there, he was also advisor to the vice minister and founding head of the strategic purchasing department at the Program for Health Assurance and Purchasing (PHAP). Alghamdi is a certified family physician and has practiced in various capacities at Saudi Aramco since 2002. In 2012, he was appointed medical director at Saudi Aramco Medical Services Organization, following other executive positions. Alghamdi received his bachelor of medicine degree from King Saud University and followed this with a residency program at the University of Toronto.

How do you envision strengthening the health insurance landscape in Saudi Arabia?

CCHI's mandate is to regulate the technical aspects of the private health insurance sector in the Kingdom. We do this together with the Saudi Arabian Monetary Authority (SAMA), which regulates the financial aspects of insurers. CCHI's remit is the technical aspects of private health insurance including coverage, access, quality, efficiency, and transparency. We aim to be a pioneer in enhancing the quality of health services by raising the efficiency of private health insurance. To achieve this, we will catalyze the private health insurance sector to the highest standards of access and care via four levers. The first is working together with SAMA to deliver a vibrant regulatory sector that focuses on outcomes, efficiency, and transparency. The second is digital transformation, and a major aspect of this will be the upcoming national private health insurance data exchange platform, formerly called Saudi Health Insurance Bus (SHIB), which will be a game changer in increasing the transparency and quality of health insurance information. The third is fostering innovation to strengthen the quality of healthcare services. This will be achieved through the drive towards value-based healthcare (VBHC), where the individual forms the center of the process, and results are the basis for performance of the health insurance system. The fourth is an internal one but just as crucial—CCHI having a thoroughly motivated and professional workforce. Our teams are our greatest asset to enable the transformation of our organization to help build the private health insurance sector to a significantly higher state of quality, transparency, and efficiency. We thus serve our key stakeholder groups—the end beneficiaries, their employers, the payers (insurance firms), and the providers who deliver the care—by encouraging and facilitating higher standards in every aspect and by ensuring a sustainable and vibrant marketplace.

Could you tell us more about the digitalization of the healthcare insurance infrastructure?

SHIB and Saudi Arabian national electronic health records (SeHe) will form the digital unified platform. When launched, all private health insurance transactions will be on this system. The level of transparency and quality of data available will be enormously important in understanding where we need specific changes and improvements and how best to do so. More importantly, processes will move faster, with lower costs overall and greater efficiency and quality. We can also significantly reduce waste, fraud, and abuse of the private health insurance system because everything will become significantly more transparent. We can identify beneficiaries, for instance, through biometric and other digital means. In turn, this will again improve the efficiency and quality of the overall sector, which will benefit the employers and end beneficiaries.

How do you envision consolidation in the insurance sector, and what should be the conditions for private insurance firms to operate in Saudi Arabia?

The private health insurance sector in Saudi Arabia currently has a gross written premium (GWP) of around SAR20 billion annually, through around 11 million end-beneficiaries. This excludes the Umrah and Hajj pilgrims who are now covered with health insurance through their visas. Our estimates indicate that by 2030, the private health insurance sector will cover around 60 million people, including citizens, residents, pilgrims, and tourists. This will mean a GWP of around SAR60 billion annually, which shows the healthy growth potential for the sector. The payer has an important role to play in introducing innovation and products that add value to beneficiaries. SAMA is now considering allowing more international firms to enter the market, which will increase competition. We welcome this news and support this direction, because it will help build a market that is more mature, efficient, and of a higher quality. Together with SAMA, we will continue working to ensure the private health insurance sector remains healthy and sustainable for all stakeholders.