DHA Announces Implementation of Diagnosis-Related Group (DRG) for the Health Sector in the Emirate
Dubai, United Arab Emirates, September 27, 2020: The Dubai Health Authority’s (DHA’s) Dubai Health Insurance Corporation announced today the introduction of diagnosis-related group (DRG) for all hospitals in the emirate.
The move came into effect this month, however, it has been in the pipeline for over four years during which active consultation and stakeholder engagement with the private sector took place.
DRG helps health insurance companies categorize hospitalization costs. Rather than paying the hospital for each specific service that was provided, a private insurer will pay the hospital a predetermined amount based on the patient's Diagnostic Related Group. This DRG is based on a variety of metrics including patient diagnosis, prognosis and various other factors.
DRG is a widely adopted model across countries including Canada, Germany, New Zealand, Australia, Singapore and Hong Kong.
The DHA discussed today the Emirate’s model of DRG and the Dubai Health Insurance system during a virtual meeting that was organized by the Authority in partnership with the Supreme Council of Health of the Kingdom of Bahrain. The virtual meeting took place in the presence of H.E. Humaid Al Qutami, Director General of the Dubai Health Authority and HE Lieutenant-General Dr. Shaikh Mohammed bin Abdullah Al Khalifa, Chairman of the Supreme Council of Health of the Kingdom of Bahrain and Ebrahim Al Nawakhtha, Secretary General, Bahrain Supreme Council of Health. From the DHA, Saleh Al Hashimi, CEO of the Dubai Health Insurance Corporation, Dr. Mohammad Al Redha , Director of Project Management Office, Health Informatics & Smart Health at Dubai Health Authority and other senior officials attended the meeting.
Al Qutami said that the DHA is keen to explore collaboration and corporation between the two entities especially for key areas such as health insurance.
He provided an overview of the health insurance system in the Emirate, its achievements and highlighted the recently introduced DRG model.
HE Lieutenant-General Dr. Shaikh Mohammed bin Abdullah Al Khalifa, Chairman of the Supreme Council of Health of the Kingdom of Bahrain
highlighted the importance of such bilateral opportunities to discuss pertinent health topics such as health insurance and primary healthcare with an aim to exchange expertise and promote knowledge transfer to further help enhance the health systems of both countries with an aim to provide the highest quality of care to patients.
Al Qutami highlighted the benefits of DRG for the overall health sector in Dubai and said that it will increase efficiency, further improve provision of healthcare and reduce healthcare costs.
Saleh Al Hashimi, CEO of the Dubai Health Insurance Corporation said, “The implementation of DRG will undoubtedly help both providers and payers and most importantly it will benefit patients as it will further drive up efficiencies in inpatient care, it will improve quality of care across the spectrum and it will encourage cost reduction which will help build a robust and dynamic health sector.”
Al Hashimi added, “We believe that DRG’s will cause a shift in paradigm from being a fee for service market environment to a pay-for-performance and get rewarded for clinical outcomes market. Payers will have to continue to get creative with offerings to cater to different sections of the market and some may eventually create a niche for themselves, while providers will have to compete on quality outcomes. The implementation of DRGs focuses on benefitting patients as it will lead to improved efficiencies and quality of patient care. In the DRG payment model, bundle payments encourage hospitals to be more cost effective in their care delivery. As a result, the cost of healthcare and premiums will reduce overtime. Hospitals will become more efficient, leading to improved patient outcomes and increased patient satisfaction while reducing waiting time for approvals.”
He said the implementation is in line with the Dubai Health Authority’s(DHA’s) Dubai Strategy for Healthcare 2016-2021 as DRG will help further enhance the quality of medical insurance.
Al Hashimi added health care financing has been the primary use for DRG implementation worldwide but there are many other benefits of the DRG model as well.
In addition to controlling the rising cost of health care expenditure, eliminating waste, helping resource distribution objectively and equitably, creative incentives to deliver cost effective and high quality of care; DRG will also help with enhancing transparency, it will help benchmark and monitor quality across hospitals and countries.
It will also helps maintain high standards of medical practice, clinical pathways and protocols which will help ensure hospitals and health care providers adhere to unified protocols of health.
Moreover, Al Hashimi added that the health sector will also benefit due to planning and research as DRG will provide evidence-based data that can be used to device public health policies with an aim to improve the health and wellbeing of the community.
Since 2016, DHA has comprehensively liaised with healthcare providers and updated them regularly about the implementation of DRG.
In 2017, the DHIC begin the implementation of DRG codes as part of the Dubai Medical Coding Manual. Additionally, more than 160 educational seminars have been conducted during this time on topics including shadow billing and the full implementation of the DRG.
Additionally, the DHIC provided communication materials and support on important topics such as DRG Payment Parameters Methodology Guidelines and the DHIC continues to support hospitals in this endeavour. Even today, post go-live the DHIC continues to have Collaborative Working Group sessions with all stakeholders.
Al Hashimi said, “The health sector in Dubai is robust and implementation of the DRG will further drive efficiencies and help bolster the health sector in the Emirate.”
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