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Health & IT

Health & IT. Ovidiu Racoveanu Head of life & health department Generali Asigurari S.A. 1. Health Information Technology – Benefits 2. Romanian Public Health Insurance System 3. Romanian Private Health Insurance System 4. Generali private health insurance offer.

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Health & IT

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  1. Health & IT Ovidiu Racoveanu Head of life & health department Generali Asigurari S.A.

  2. 1. Health Information Technology – Benefits2. Romanian Public Health Insurance System3. Romanian Private Health Insurance System4. Generali private health insurance offer

  3. Healthcare – data from U.S., 2004 No harmoniza-tion on health IT standards 1,5 Mio. People suffer each year from drug errors in hospitals Missing info was the root of 80% of mistakes Health problems Not affordable care High costs 1/7 from the needed medical files were missing Between 44.000-98.000 people die yearly from preventable medical errors Source: www.hhs.gov/healthit

  4. Role of IT - Benefits to the health-care consumer Reduction in medical errors Higher quality care Decrease in paperwork Affordable care IT Lower costs Constant access to health information Fewer duplicate treatments and tests Source: www.hhs.gov/healthit

  5. Role of IT - Benefits to the public health Improve tracking of chronic diseases Early detection of infectious diseases Research database Easy evaluation of medical procedures IT Fraud detection Health information exchange (privacy and security policy) Electronic health record (US: by 2014, according to President Bush) Source: www.hhs.gov/healthit

  6. Romanian Public Health Insurance System • Institutions, insured persons and funding of the activity • The National Social Health Insurance (NSHI) is government-operated and responsible for 65% of health expenditures in the country. • According to the law, 100% of the population is supposed to be covered by the NSHI. • NSHI is funded through taxes from employees and employers: 7% and 6.5% of the workers’ pre-tax salaries (total 13,5%). • Informal payments were $1 million per day (estimate, World bank, 2005).

  7. Romanian Public Health Insurance System • Basic package (NSHI): • Medical services, care services, drugs etc.; these costs could be totally or partially covered by the fund. • The main coverage are the following (for insured persons, or children under 18): • Any diagnostic, treatment, hospitalisation or surgical intervention that are related to an emergency case; • Free access to the family doctor; • Free access to specialized physician; • Drugs free/partially free; • Drugs, treatment etc for some special persons (having critical illness, e.g. diabetes,cancer, HIV); • One medical check-up a year (in the month of birth).

  8. Romanian Public Health Insurance System • Medical treatment: • Primary level is provided by family doctors and some GPs. • Secondary levelor the ambulatory level, where specialistsdoctors provide advanced medical care (visit, diagnostic, laboratory tests) in all medical specialties. • Tertiary level(hospitals) includes all public hospitals. • Market overview (data available for 2004): • Health accounted for 6,4% from the GDP. • Health payment per capita was $128.

  9. Major problems in the Romanian Public Health Insurance System • Major problems: • Queuing. • Old equipment in some of the county clinics and hospitals. • Co-payments and informal payments are needed. • Long-term care component provides only very small amounts as pension. • Laboratory tests are only partially covered. • Limited access to best doctors. • Uncomfortable rooms in case of a hospitalization.

  10. Romania Private Health Insurance • In a nutshell: • Main players: Allianz, Generali, Interamerican, Aviva. • Other foreign companies are trying to set up insurance companies (e.g. Signal Iduna). • Fiscal deductibility valid for employers: up to 200 EURO premiums / year for each employee. • Unclear and restrictive package of laws.

  11. Generali’s Offer for Private Health Insurance • Products: • Indemnities paid to the client: Clasic Grup; • Indemnities paid to the health provider: Vital Plus. • Health providers in Romania: • Around 30 clinics and hospitals, both private and public. • Worldwide health network: • Professional call-center by EUROP ASSISTANCE.

  12. Generali’s Offer – Clasic Grup – Indemnities paid to the insured person • Requirements: • > 20 lives • all members included • Advantages: • Free coverage • Worldwide coverage • Profit – sharing schemes

  13. Generali’s Offer – Vital Plus – Indemnities paid to the health provider • Requirements: • > 10 lives • Advantages: • Additional coverage for major surgical intervention, long term care • Coverage in Romania • Worldwide extension of the coverage

  14. Best practice – Exchange of data Client Call-center Database Medical provider Generali

  15. Generali’s Offer for Private Health Insurance • Other benefits: • No queuing. • Contracts with the best clinics and hospitals worldwide. • No co-payments or informal payments. • Long-term care component can be added to the scheme. • Full coverage (within the limits of the contract). • Access to best doctors worldwide. • Hospitalization in comfort rooms.

  16. A Choice of Generali’s International Clients

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