Page 1

MULTI-NATION BUSINESS CONTINUITY TASK FORCE HEALTHCARE SECTOR WORKSHOP NOTES & RECOMMENDATIONS 30 AUGUST 2020


About the Multi-Nation Business Continuity Task Force Initiated by AmCham Dubai and AmCham Abu Dhabi to mitigate the impact of the COVID-19 pandemic, the Multi-nation Business Continuity Task Force aims to gauge sentiment, assess business continuity challenges and support the wider business community on specifics that require UAE government assistance. The task force aims to provide a channel of communication for its members and is committed to supporting members on an individual basis where possible, in addition to presenting common strategic themes at the government level.

The MNBC Task Force is supported by


Healthcare Working Group 3 Main Focus Areas Healthcare industry experts convened and engaged in a robust and fruitful discussion to identify what they perceived were the opportunity areas for improvement within the healthcare sector in the United Arab Emirates. These centered around 3 main focus areas: 1. Define the healthcare industry’s most urgent business challenges 2. Define actionable solutions to these challenges, with timelines (short-term and longterm) 3. Define what regulations are potential roadblocks to implementing these solutions, and suggest changes using best practices, global experiences, and key insight from leading companies

3


Recommendations will be Addressed at the Federal Level and Emirate Level As healthcare policies and actions are executed at different levels within the UAE, the document separates the policy recommendations and implementation at two levels; at the Federal level (UAE Ministry of Health and Prevention) and at an Emirate (local) level. UAE Federal Level (UAE Ministry of Health and Prevention) Emirate (Local) Level Abu Dhabi

Ras Al Khaimah

Ajman

Dubai

Sharjah

4

Fujairah

Umm Al Quwain


Federal Recommendations from Task Force 01

Review and standardization for physician credentialing and licensing across the UAE

02

The Advancement of Healthcare Technology

05

The Role of Insurance

06

Access to Medication (particularly for new medications and those for treating rare conditions/diseases)

03

Incentive Programs for Physicians and Healthcare Providers

07

Review the overall healthcare workforce

04

Improve the Role/Engagement of Medical Associations & Societies and Increase Involvement in the medical community

08

Regulatory Framework Across the UAE

5

Federal & Local Implementation


Federal Recommendations from Task Force 09

COVID-19 → Legally under Force Majeure?

13

Chronic Disease Management & Infrastructure Readiness

10

Reimbursement/Pricing

14

Healthcare Communication

11

Oversupply vs. Capacity Gaps of Clinical Services

12

Clarity of Regulations Surrounding Foreign Direct Investment (FDI)

6

Federal & Local Implementation


Federal Recommendations from Task Force

1

Review and standardization for physician credentialing and licensing across the UAE

• •

• •

2

Healthcare Technology • •

In addition to looking at where a physician or healthcare provider graduated, their experience and competencies should also be considered while granting a license to practice and afterwards, in order to elevate the level and quality of care Licensing should be the same across all Emirates without additional fees/licensing process.

While UAE follows advanced medicine, bringing new medical technology in diagnostics and treatment takes a long time, thus by the time the “new” technology arrives it may be old. The private sector could be encouraged with incentives such as carve out contracts, concessions, etc. Bringing the latest technology to hospitals and clinics so residents can find the equivalent in their home countries. As a result, more residents and citizens will have treatment here than abroad or back home. Now is the perfect opportunity as people wish to travel less due to COVID-19. Reimbursement is behind on technology. Often because they are not certain if the volume is there, but this piece should also be reviewed. More PPPs (Public Private Partnerships)

7


Federal Recommendations from Task Force

3

Incentive Programs for Physicians and Healthcare Providers

•

Many doctors and others come here for commercial opportunity. Creating some kind of incentive program where the UAE is seen as a long-term home, rather than a temporary financial opportunity. Perhaps expanding the gold visa program to more physicians, healthcare professionals and scientists could be an option.

•

4

Improve the Role/Engagement of Medical Associations & Societies and Increase Involvement in the medical community

The process of Medical Association registration, and the way they are defined as an entity may be reviewed. For example, some Medical Associations are not able to get visas to hire admin help. Perhaps reviewing laws and regulations around what these entities can and cannot do can get them more engaged through their relevant specialties. Some best practices from other countries includes deeper medical association involvement in setting national clinical standards, developing policy, etc.

•

8


Federal Recommendations from Task Force •

5

The Role of Insurance

6

Access to Medication (particularly for new medications and those for treating rare conditions/diseases)

Review the overall healthcare workforce

7

Insurance companies need more information and understanding about new technology and how to reimburse Review equality in insurance coverage

The process of Medical Association registration, and the way they are defined as an entity may be reviewed. For example, some Medical Associations are not able to get visas to hire admin help. Perhaps reviewing laws and regulations around what these entities can and cannot do can get them more engaged through their relevant specialties. Some best practices from other countries includes deeper medical association involvement in setting national clinical standards, developing policy, etc.

With COVID-19, look at how nurses and other essential healthcare workers can travel to the UAE and start working

9


Federal Recommendations from Task Force •

8

Regulatory Framework Across the UAE

4 separate regulatory bodies in the UAE, and 2 within the same Emirate (Dubai), present the challenge of varying regulations for the same business activities. There is duplication of work/efforts, it is more costly to achieve business objectives, and there is confusion of regulatory requirements when business activities span the country This is exacerbated by the UAE’s relatively small population (<10 million people)

Actionable Solution: • Unify regulatory requirements for business activities across all 4 regulators

• •

9

COVID-19 → Legally under Force Majeure?

Lack of clarity on whether the impact of COVID-19 falls under Force Majeure? If so what are the entitlements businesses have as a result? Subsidies? Rent deferrals? Concerns also raised about reported 70% of businesses in Dubai will/projected to be insolvent. This will have long-term, detrimental effects on business growth and continuity in the Emirate, and the wider UAE

Actionable Solution: • Present and share one unified UAE government stance, communicated consistently across all government entities, that clarifies what business and individual entitlements are as a result of the COVID-19 pandemic 10


Federal Recommendations from Task Force •

10

Reimbursement/Pricing (Federal & Local Implementation)

The need for pricing certainty was highlighted. Currently there is a lot of uncertainty when it comes to pricing, as contracts are being (re)negotiated with insurers on an annual basis. This makes it difficult to forecast/plan for future operational activities or growth, particularly when it involves delivering the same or superior quality This also presents a challenge for investors looking to invest in the UAE. They create business models with little to no certainty of their ability to achieve their projected revenues or stay within their projected costs, or even if they can get contracted with insurance providers This is a key business driver for the healthcare sector, currently and into the future

Actionable Solution: • Provide pricing clarity for the delivery of clinical services for healthcare providers through longer finalized pricing periods (as opposed to annual revisions). • Recommended 3 – 5-year periods at a time • Create a unified platform to express the pricing-related feedback from healthcare providers in the emirate & country

11


Federal Recommendations from Task Force •

11

Oversupply vs. Capacity Gaps of Clinical Services (Federal & Local Implementation)

This is constant across the UAE. There are certain clinical services that are in plentiful supply, while others are in a shortage (across the country and within emirates). There is also an imbalance between availability of services in the public vs. private sectors Examples of clinical service line shortage across the country is Mental Health. An example of imbalance is Pediatric Sub-Specialties. With these shortages/imbalances, two main challenges are there: • There is a need to fly in international experts to deliver needed care, and this comes at a high cost and requires many “hurdles” (ex: getting them licensed) • Clinical utilization is lower than benchmarks, and that impacts skilled delivery of care with imbalanced provider availabilities An opportunity also highlighted was to look at mandates. Specifically, incentivize addressing capacity gaps through Activity-Based Mandates payments

Actionable Solution: • Strengthen public-private partnerships to address country-wide capacity gaps and strike a healthy balance of provision of services between public and private sectors

12


Federal Recommendations from Task Force •

12

Clarity of Regulations Surrounding Foreign Direct Investment (FDI)

It was highlighted that there has been significant improvement in the ease of doing business in Dubai, particularly around the rules on FDI. However, there remains lack of clarity on how FDI regulations differ between different Emirates. The concern raised is entering the Dubai market successfully does not guarantee success in other Emirates Belief that there is a lot of value that can be added by scaling the same FDI successes achieved in the Dubai to the wider country. These include creating more jobs and localizing manufacturing in the country

Actionable Solution: • Re-visit emirate-specific regulations to align with country-wide strategy around FDI

13


Federal Recommendations from Task Force • •

13

Chronic Disease Management & Infrastructure Readiness (Federal & Local Implementation)

This topic was part of the wider discussion around patient access. Specifically, barriers to access demonstrated by fragmented referral systems and places to deliver care, particularly tertiary level care (therapies, surgeries, etc...) This is magnified during the current COVID-19 pandemic. An example to illustrate this is out-of-hospital cardiac arrests, which have increased 50% during the pandemic From a medium-to-long term perspective, the UAE and wider GCC have a relatively young population. The concern is the continual growth of chronic diseases in these younger populations, and them living with these diseases for a long time will present a heavy strain on the sector The infrastructure in the UAE may not be ready to handle this significant growth in chronic diseases across the population. The link back to FDI was discussed, and the ability of companies to partner with the government to address these infrastructure gaps

Actionable Solution: • Analyze the extent of chronic disease prevalence in the young population in the UAE, and the country’s infrastructure needs to handle diseases growth in the future. Strengthen public-private partnerships to address infrastructure gaps

14


UAE Government Communication

14

It was reinforced that the UAE government’s efforts to keep individuals and businesses safe during the current pandemic was sincerely appreciated. The outcomes compared to the rest of the world speak for themselves, and the UAE has in many ways been a role model of maintaining a safe society in the midst of a viral pandemic

In the spirit of improvement it was highlighted that the communication cadence, comprehensiveness, and consistency from government to the healthcare sector could be improved upon. For example, during the current COVID-19 pandemic there is conflicting messages from coming from different government entities on businesses re- opening requirements, individual and business entitlements, what is and isn’t allowed, and so forth

It was brought to the group’s attention that a separate working group focused exclusively on optimizing communication between government and businesses is working on this, with outcomes to be shared to the wider task force

Healthcare Communications

15


Emirate (Local) Level Recommendations from Task Force 01

Clinical Licensure

02

Consolidation vs. Contraction

03

Variance of Care Quality

04

â&#x20AC;&#x153;The Middlemanâ&#x20AC;? 16


Emirate (Local) Level Recommendations from Task Force •

01

Clinical Licensure

It was recognized that the licensing requirements for all clinical licenses, across the 4 regulatory bodies in the UAE, have recently been standardized. This is a big achievement and is welcomed by healthcare providers across the country However, the licenses are still issued from the 4 different regulators, so therein remains opportunity to improve, as timelines for license issuance still vary according to the respective regulator This impact is particularly felt across health systems, and with the increasing consolidation the industry is undergoing this becomes increasingly more important Another identified challenge is the length of time it takes for a license to be issued. Averages range between 6 – 12+ months, and with the attrition rate within healthcare organizations in the UAE, backfilling positions to meet operational needs is challenging

Actionable Solution: • Standardize license issuance by issuing the same license from all healthcare regulatory bodies • Shorten the timeline it takes to issue a clinical license, recommended to within 3 months

17


Emirate (Local) Level Recommendations from Task Force •

02

Consolidation vs. Contraction

The underlying desire/thought process of the healthcare sector members is for the sector itself to thrive. With that it was recognized that consolidation within the sector is generally a good thing. It improves outcomes, increases efficiencies, and reduces costs, among other benefits However, it was advised that consolidation should not occur at the expense of overall contraction of the sector. This is not healthy for the long-term viability and sustainability of the sector

Actionable Solution:

Maintain open dialogue between government and key healthcare sector players, through ongoing communication mechanisms, to ensure financial stewardship and long-term sustainability of the sector while avoiding sector contraction

JAWDA is acknowledged as a step in the right direction for ensuring healthcare quality. But there remains a large variance in care quality across healthcare providers. Payments for clinical care are more or less the same, despite the variance in care quality Standardizing the “floor” of care delivery across the sector is vital. Will help with data generation for continuous improvement possibilities, local benchmarking, and so forth

03

Variance of Care Quality

Actionable Solution: • Link quality outcomes to payment mechanisms/schemes to “raise the floor” of the minimum quality standards prevalent across the industry • Incentivize high-quality care delivery through “bonus payments” for regularly exceeding 18 quality thresholds


Emirate (Local) Level Recommendations from Task Force

04

“The Middleman”

• From the industry perspective, the concept of having a “middleman” between a company and patients brings with it a number of challenges: • “Middlemen” may be driven by financial incentives vs. what is in the best interest of patient care delivery • It limits the ability of industry to better understand the needs of their customers and the markets they operate in • The ability to tailor products to local needs is also compromised, as industry relies on the input of a 3rd party as opposed to hearing these needs directly from their customers. The needs of patients around the world are not the same • This was overcome on a significant scale in Saudi Arabia, where direct lines of communication to customers was achieved. So there is precedent in the region • A real-world example of how this challenge manifests is stopping or delaying the procurement of critical medicines or equipment to the country if they no longer agree/want to change the business terms and conditions with the owner of the license. This is a unique challenge that other countries do not share, and impacts patients’ access to these critical needs Actionable Solution: • Re-visit regulations to allow healthcare industry companies to directly interact with their customers • Work with the current “middleman” companies to re-purpose their operations towards addressing operational gaps in the healthcare sector to allow the sector to continue to thrive into the future


MULTI-NATION BUSINESS CONTINUITY TASK FORCE HEALTHCARE SECTOR WORKSHOP NOTES & RECOMMENDATIONS

Profile for AmCham Dubai

MNBCTF Healthcare  

MNBCTF Healthcare  

Profile for abcdubai

Recommendations could not be loaded

Recommendations could not be loaded

Recommendations could not be loaded

Recommendations could not be loaded