Dubai - Hospitals have already started shadow billing to understand how the system works.
Published: Mon 3 Jun 2019, 10:54 PM
Patients in Dubai hospitals will soon be able to pay for 'bundled' treatments instead of paying separately for services and medications.
Starting September, hospitals in Dubai will adopt the International Refined Diagnostic Related Groups (DRGs) for inpatient hospital payments, in which services will no longer be charged individually.
The Dubai Health Authority (DHA) is adopting this health insurance payment model and regulation to ensure the sustainability of the Dubai health system by providing incentives for improved efficiency and quality. "The DRGs bundle or combine inpatient hospital services into a single group for each inpatient stay," Saleh Al Hashimi, CEO of the DHA's Dubai Health Insurance Corporation (DHIC), told Khaleej Times in an exclusive interview.
"The hospital services included in each DRG bundle represent the typical services provided across all hospitals for inpatients with similar reasons for admission," he said. Up to 700 such services have been identified.
"For example, if a doctor is not satisfied with an X-Ray and requests another and then another, the patient will be charged for only one, instead of the three," explained Al Hashimi.
Each patient's hospital stay is assigned to only one DRG, based on the patient's age, sex, diagnoses, procedures provided to the patient, and, sometimes, other factors.
The DRG payment system uses a series of parameters for calculating the specific payments to be made to hospitals for each inpatient stay.
"The price is fixed irrespective of the fact that the patient stays in the hospital for two or 20 days," said Al Hashimi.
"The payer will not be charged extra for the stay or medications, and if there are treatment-related complications up to four weeks after being discharged, medications will be given in the same package," he said.
Hospitals have already started shadow billing to understand how the system works.
"We are working to bring the same concept to outpatients as well," said Al Hashimi.
He said the system would make hospitals more efficient. "It is not in their favour to keep patients in the hospital for long."
Al Hashimi said patients can benefit by recovering at home, while hospital beds can be used more efficiently with a higher turnover.
"The payer will also not have claims adjucation rejections because they will become minimal," he said.
Technology, coding and interfacing is being used to set up the system. "In this way, the government also collects more accurate data that will be used to devise public health policies and promote healthier lifestyles in the future," added Al Hashimi.
asmaalizain@khaleejtimes.com
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