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Wo Working wi with Assistance ce Companies es A ‘Provider ers’ p perspec ective

Ab About T t The Mc McGrigo gor Group p

James McGrigor (UK, CEO) Key Focus – Growth Consulting for Insurance & Health Service Co’s David Vogdt (France, Partner) Key Focus – Int’l Development for Medical Providers

=> 25+ years; 400 advisory projects; 40 acquisitions; Int’l patient provider experience; a truly global perspective from Mexico to China => 4 main activities: Consultancy, M&A, Publishing (IPMI/PHM), Specialty

• Client Examples:
• PAYERS - International Private Medical Insurers (Cigna, BUPA, MSH,..)
• PROVIDERS: PHF (Paris Hospital Foundations); Clinalliance Group (Fr)
• SERVICE CO’s: Third Party Administrators (MSH, NEXtCARE); Assistance companies (ISOS,

AXA Assistance, Asia Assistance..); Cost containment co’s and medical facilitators (Medigo..); Health and wellness providers (Optum..)

• GOVERNMENT BODIES: WHO; Multiple MOFA and MOH eg (Benin, Morocco, Spain)

Abou

• ut the PHF

HF Ho Hospital Grou

• up

The Foch Hospital, the Rothschild Foundation Hospital and Diaconesses Croix Saint-Simon Hospital Group: Leading Hospitals in France in several fields such as Neurology, Neurosurgery, Pneumology, Oncology, Urology, Orthopaedics, Ophthalmology and others.

• 3 General Hospitals, offering over 1000

Hospital Beds

• Over 1000 Employed Physicians in 3 Hospitals
• No doctor fees applied
• Covering around 90% of the Medical

Specialities

• 3 Teaching Hospitals

Qu Ques estion

• n of t

the day: How w should Assistanc nce compa panies & p provide ders work together, , give ven the situational pres essure? e?

Assistanc nce c compa panies - Role & Main criteria

=> Role

Place patients with Urgent medical needs

⇒ 4 main criteria for Providers, also called the 4 pillars are:

• Medical Excellence
• OPs efficiency (quick responses, fluid communication,

ability to speak foreign languages, to accept GOP, to bill internationally etc.)

• Cost-containment
• Credentialing

These are the main priorities reflected in figures used to calculate the global ranking with different weighting. Above a certain grade, the local network manager can assign the “Preferred” status to the provider.

PROVIDER

?

Provi vider r - Role

• le & Expectatio

ion

ASSISTANCE COMPANY

=>Provider

• Treat patients

=> Priorities & Expectations:

• Provide quality medical care
• Have accurate medical information before arrival (including Lab,

Images, updated status of patient)

• Have solutions for patients departure once treatment is

considered finished (Eg: Recovered or medical project has come to and end) – Avoid a bed blocker

• Get paid, easily, quickly
• Repeated activity. Don’t become the Plan B when others fail to

accept

?

=> Role

• Place patients with Urgent medical

needs => 4 main criteria's for Providers, also called the 4 pillars are:

• Medical Excellence
• OPS efficiency (quick responses,

fluid communication, ability to speak foreign languages, to accept GOP, to bill internationally etc.)

• Cost-containment
• Credentialing

=> Role

• Treat patients

=> Priorities:

• Provide quality medical care
• Have accurate medical information

before arrival (including Lab, Images, updated status of patient, …)

• Have solutions for patients departure
• nce treatment is considered finished

(Eg: Recovered or non treatable) – Avoid a bed blocker

• Get paid, easily, quickly
• Repeated activity. Don’t become the

Plan B when others fail to accept

Possibl ble a area ea

• f fr

f friction

Match

Areas as of frict ction: Matching r

roles, di , different pr priorit ities…

Possible area o

• f f

f fricti tion Solving friction

Criteria Assistance Company Provider Solution Medical Excellence Primary Primary Keep good Ops Efficiency Primary Secondary, according to general activity Have primary admin & medical contact Cost-containment Primary Last Arrange 2 way benefit according to growth with clear pricing Credentialing Primary Administrative burden Publish it, open source Have accurate medical information upfront Works with available information Medical teams refuse without information Connect medical teams and build trust Have departure solutions Depends on Assistance

• companies. Sometimes

abandon patient after delivery Can not have a bed blocker situation Define exit scenario upfront or don’t do the

• mission. Will damage

relationship otherwise Get paid, easily, quickly Depending on 3 party for payment Do not wish to run after their money Build money recovery into price, speedy payment discounts Repeated activity Based on relationship with providers, tend to work with preferential network Become frustrated if they are only a Plan B when others fail Don’t send cases that are not likely to happen

Possi sible w e ways t s to impr

• prove. S

Simple c cha hanges, bi s, big i g impa pact

Concl clusion: Building a an e emotional r relationship

Ask y yoursel elf b before e e engaging ng

• Provider: Am I a potential medical partner for Assistance Companies (High Performing ICU,

heavy case management, close to International Airport, etc)

• Assistance company: How much of a network do I need in the region? (Avoid signing without

bringing volume..)

• Consider each others priorities when negotiating with a potential partner
• Adapt & make changes to internal procedures (Eg Billing)
• Improve communication to focus on mutual key priorities
• Introduce medical teams to understand each other’s processes
• Meet on a regular basis

THAN ANK Y YOU