Alternative Reimbursement Models
Developing Alternative Reimbursement Models for Hospital Admissions related to COVID-19
When the COVID-19 epidemic began, the possibility of medical schemes being exposed to the costs was flagged as a risk. COVID-19 was further classed as a prescribed minimum benefit (PMB), which increased the risk. As a result, the concept of an ARM for COVID-19 hospital admissions was investigated as a feasible risk-mitigation strategy.
BHF spearheaded this initiative in collaboration with an industry Task Team consisting of actuaries and two industry clinicians. It is hoped that this initiative will empower various healthcare stakeholders to create alternate reimbursement arrangements that can improve the resilience of our healthcare system in the fight against COVID-19.