Developing the First Mandatory Health Insurance, E-claims and Data Management

CLIENT

A government authority in Saudi Arabia.

ISSUE

The main objective is to create a system that would allow the government to obtain critical and standardized information for every patient, hospital and clinic in its jurisdiction.

• 1) Standardized definition and regulation of pricing of medical service.
• 2) E-claims system creation and implementation for integrated data management.
• 3) Healthcare infrastructure capacity building (i.e. technology, IT, digital)
• 4) E-health programs and other innovative initiatives

APPROACH

Our team conducted a deep dive on the issue, detailing key elements of the health insurance strategy, infrastructure and policy development which led to a comprehensive implementation plan​. Based on the thorough analysis and insights, the team was able to create a system that enabled the government to make strategic decisions regarding the direction of healthcare in the country.

ENGAGEMENT ROI

Our integrated deliverables successfully helped the client to better understand and equip them in:

• 1) Identifying greatest health threats in the community.
• 2) Identifying most prescribed medication.
• 3) Resource allocation and cost-cutting initiatives through cutting redundancy and implementing greater efficiency.
• 4) Disaster and epidemic planning
• 5) E-health and preventative medicine programs