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CONNECT: SUBSCRIBE: Digital / Print / eNewslette PREV MGMA research reflects importance of transpar ... Debate rages on over new mammogram guidelines ... NEX RESOURCE CENTERS PARTNER CONTENT Idiopathic Pulmonary Fibrosis Preparing for ICD-10 Meaningful Use 2 Oncology: Practice Management Chronic Disease M HOME INDUSTRY ANALYSIS BUSINESS STRATEGY HEALTH MANAGEMENT HOSPITALS & PROVIDERS PHARMACY BEST PRACTICES TECHNOLOGY COMMEN Managed Healthcare Executive Chile's healthcare offers public and private plans Chronic care has guarantees December 01, 2009 By Mari Edlin DIGGING INTO REFORM Spending 5.4% of gross national product, or about $689 per capita, on healthcare, Chile is still readjusting to a reform initiative that began in 2002. It is tackling objectives in phases. Initial goals are to address inequities and disparities in healthcare, strengthen the focus on primary care, reduce waiting time in the public sector, introduce more competition into the ISAPREs market, improve efficiencies and care for the evergrowing senior population. Among the new laws that are key to reform is what's known as the AUGE Plan (in English: the plan for universal access with explicit guarantees). AUGE specifies four basic guarantees for healthcare concerns related to 56 defined health conditions, based on the highest burden of disease, effectiveness of treatments and highest cost. Guarantees include: access, timeliness, quality and financial protection. Twenty four more conditions are slated for inclusion next year. In short, AUGE guarantees a basic, uniform benefit plan, which applies equally to beneficiaries of public and private insurers. "If you are a supporter of Chile's reforms, AUGE guarantees access and assures quality," says Bruce Pollack, president of AIHS and MHE editorial advisor. "Detractors refer to the methodology as rationing." One delegate, Gabriel Hanna, president and CEO of DC Chartered Health Plan based in Washington, D.C., says he does not believe that there is any competition between the public and the private healthcare sectors in Chile. "Those who can afford to buy private coverage will receive much better access—no waiting list—to a somewhat better delivery system. On the other hand, competition among private insurers seems to exist based on levels of care and price; however, with only 13 private insurers to serve the entire country, it appears to me that there is some competition, but it doesn't appear to be fierce," Hanna says. Chile has a public plan covering the majority of lives, but it is not driving the private plans out of business, according to delegate Margaret Murray, CEO, Association for Community Affiliated Plans also in Washington, D.C. TRENDING: Idiopathic Pulmonary Fibrosis Preparing for ICD10 Meaningful Use 2 Oncology: Practice Management PUBLICATIONS BUSINESS CME CAREERS CONTACT US LOG IN | REGIS

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  • 02/12/2014 Chile'shealthcareofferspublicandprivateplans|ManagedHealthcareExecutive

    http://managedhealthcareexecutive.modernmedicine.com/managedhealthcareexecutive/content/chileshealthcareofferspublicandprivateplans?id=&s 1/3

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    PREV MGMA research reflects importance of transpar ... Debate rages on over new mammogram guidelines ... NEXT

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    Preparing for ICD-10

    Meaningful Use 2

    Oncology: Practice Management

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    HOME INDUSTRY ANALYSIS BUSINESS STRATEGY HEALTH MANAGEMENT HOSPITALS & PROVIDERS PHARMACY BEST PRACTICES TECHNOLOGY COMMENTARY

    Managed Healthcare Executive

    Chile's healthcare offers public and privateplansChronic care has guarantees

    December01,2009 ByMariEdlin

    DIGGINGINTOREFORM

    Spending5.4%ofgrossnationalproduct,orabout$689percapita,onhealthcare,Chileisstillreadjustingtoareforminitiativethatbeganin2002.Itistacklingobjectivesinphases.

    Initialgoalsaretoaddressinequitiesanddisparitiesinhealthcare,strengthenthefocusonprimarycare,reducewaitingtimeinthepublicsector,introducemorecompetitionintotheISAPREsmarket,improveefficienciesandcarefortheevergrowingseniorpopulation.

    Amongthenewlawsthatarekeytoreformiswhat'sknownastheAUGEPlan(inEnglish:theplanforuniversalaccesswithexplicitguarantees).AUGEspecifiesfourbasicguaranteesforhealthcareconcernsrelatedto56definedhealthconditions,basedonthehighestburdenofdisease,effectivenessoftreatmentsandhighestcost.Guaranteesinclude:access,timeliness,qualityandfinancialprotection.Twentyfourmoreconditionsareslatedforinclusionnextyear.

    Inshort,AUGEguaranteesabasic,uniformbenefitplan,whichappliesequallytobeneficiariesofpublicandprivateinsurers.

    "IfyouareasupporterofChile'sreforms,AUGEguaranteesaccessandassuresquality,"saysBrucePollack,presidentofAIHSandMHEeditorialadvisor."Detractorsrefertothemethodologyasrationing."

    Onedelegate,GabrielHanna,presidentandCEOofDCCharteredHealthPlanbasedinWashington,D.C.,sayshedoesnotbelievethatthereisanycompetitionbetweenthepublicandtheprivatehealthcaresectorsinChile.

    "Thosewhocanaffordtobuyprivatecoveragewillreceivemuchbetteraccessnowaitinglisttoasomewhatbetterdeliverysystem.Ontheotherhand,competitionamongprivateinsurersseemstoexistbasedonlevelsofcareandpricehowever,withonly13privateinsurerstoservetheentirecountry,itappearstomethatthereissomecompetition,butitdoesn'tappeartobefierce,"Hannasays.

    Chilehasapublicplancoveringthemajorityoflives,butitisnotdrivingtheprivateplansoutofbusiness,accordingtodelegateMargaretMurray,CEO,AssociationforCommunityAffiliatedPlansalsoinWashington,D.C.

    TRENDING: IdiopathicPulmonaryFibrosis PreparingforICD10 MeaningfulUse2 Oncology:PracticeManagementPUBLICATIONS BUSINESS CME CAREERS CONTACT US LOG IN | REGISTER

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  • 02/12/2014 Chile'shealthcareofferspublicandprivateplans|ManagedHealthcareExecutive

    http://managedhealthcareexecutive.modernmedicine.com/managedhealthcareexecutive/content/chileshealthcareofferspublicandprivateplans?id=&s 2/3

    BUSINESS &TECHNOLOGY

    WOMEN'SHEALTH

    CHILDREN'SHEALTH

    MEN'SHEALTH

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    INDUSTRYANALYSIS

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    StandardsinChile'spublicsectorneedabitoftweaking,however.Sincemanylowincomepeoplecanonlyoptforthepublicsystem,thereislittleincentiveforhighperformance,qualityandefficientmanagementfromproviders.Morethan1millionmembersarecurrentlyonawaitinglistforAUGEservices,including117,000surgeriesaswellashundredsofthousandsofmedicalappointments.

    AIHSdelegateshadanopportunitytovisitapreeminent270bed,forprofithospital,Santiago'spremiertertiarycarepublichospitalwith340beds,anda403bedprivatehospitalthatalsoservesasignificantproportionofpublicpatients.Delegatesobservedthecomparativelysuperioraccess,negligiblewaitinglistsandprivateroomsthatcomewiththeprivatehospitals.

    Anotherfieldtriptookdelegatestothe216bedClinicaLasCondes,accreditedbytheJointCommissionInternational,whichbenefitsfroma10yearaffiliationwithJohnsHopkinsMedicineInternationalandtheinstitution'sexpertise.

    TECHNOLOGYLEAVESAPRINT

    Manydelegatesagreethatoneofthemostmemorablediscoverieswastheinnovativefingerprinttechnologyusedbyallpublicandprivateproviderstoimmediatelyverifyeligibilityandbenefits.

    Thebiometricidentificationsystemcapturestheimpressionofapatient'sfingerprint,whichisthenusedasproofofidentity.Thetechnologycanalsogenerateelectronicvoucherstocoverspecificmedicalexams,procedures,treatmentsandconsults.ItisnotsurprisingthataCaliforniaSiliconValleycompanyisresponsibleforthetechnology.

    ClinicaDavilaalsoutilizescolorcodedelectronicboardsinitsoutpatientandinpatientdepartments,whichindicatethestatusofpatientsintheclinic.Asoneclinicphysicianputit,Chilefallssomewherebetweenbeinga"developingandadevelopedcountry."

    "Chile'shealthcaresystemdoesanadmirablejobofprovidingreasonablygoodcareatremarkablylowcost,"Pollacksays."Anationalfocushasbeenonpublichealthandaccesswhileguaranteeingnearlyuniversalcoverage.Thepublic/privateinterfaceworksandworkswell.Thepublicoptionisnottheoptionoflastresort,butratherthefirstchoiceformostChileans."

    MariEdlinisafrequentcontributortoMANAGEDHEALTHCAREEXECUTIVEandhastraveledwithAIHSonpreviousmissions.

    TAGS ManagedCareOutlook

    Mari Edlin

    MariEdlinisafrequentcontributortoManagedHealthcareExecutive.Sheis

    basedinSonoma,California. MORE

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