Health Insurance in KSA
Bupa Arabia Perspective
May 2015
Bupa Arabia
1
KSA Health Insurance Industry: Five Phases
PreEnforcement
(pre-2006)
Bupa Arabia
Rush for
Growth and
Capacity
Building
(2006 – 2011)
Market
Restructuring
(2011 - 2014)
Price
Adjustment
and
Innovation
(2014 – 2015)
The Future:
Continued
Growth and
Regulatory
Change
(post 2015)
2
KSA Health Insurance Industry: Pre-Enforcement
• Until the mid-1990s, insurance
was banned in KSA
• However, 100 companies were
operating via overseas offices
• Private Medical Insurance was
not a priority, as all Saudis had
access to free healthcare
• In 1999, a Royal Decree
mandated PMI for non-Saudis
and created a governing body
for health insurance, the
Council of Cooperative Health
Insurance (CCHI)
Bupa Arabia
• BUPA Middle East was
incorporated in 1997 as a JV
between Bupa Group and
Nazer to serve the Saudi
health insurance market
2006
Saudi Health Insurance Market
Lives Covered
KSA Market Bupa Arabia
2m
250k
• The company focused on
bringing together the
international health insurance
and expertise of the Bupa
Group with the knowledge of
starting up new businesses in
Saudi Arabia of the Nazer
Group
• However, growth remained low
Bupa Arabia
3
KSA Health Insurance Industry: Rush for Growth
• Growth in the market
accelerated
• We focused on building the
capabilities to deliver great
products and a fantastic
customer experience
• This meant creating an
operational structure,
consistent with the Bupa way:
− Distribution
− Branding
− Provider infrastructure
− Customer service call center
− IT infrastructure
2006
• In 2006, CCHI worked with the
Ministry of Interior to link
medical insurance to
residential and work permits
making it easier to enforce the
mandate
Bupa Arabia
2m
250k
2011
Saudi Health Insurance Market
Lives Covered
KSA Market Bupa Arabia
8m
1.2m
• Critically, it also meant the
creation of a world-class team:
− Recruiting
− Development of people
policies
− Training
Bupa Arabia
4
KSA Health Insurance Industry: Market Restructuring
• Growth in the market
continues at a significant pace
Bupa Arabia
• Bupa Arabia launched our “7
pillar strategy” which focused
on executional excellence
across the business:
− Expand Distribution
− Establish Healthcare
Leadership
− Better Manage Medical
Costs
− Improve Branding
− Improve Organisational
Capability and Capacity
2006
• At the same time, the health
insurance market underwent a
“price war” with many
competitors charging prices
below medical costs
• We continued to focus on our
core advantages: our
healthcare credentials, our
excellent customer service and
our relationship with
corporates throughout the
Kingdom
2m
250k
2011
• In this period, the supply of
healthcare facilities did not
kept pace with the growth of
health insurance. This is put
upward pressure on medical
costs
Bupa Arabia
8m
1.2m
2014
Saudi Health Insurance Market
Lives Covered
KSA Market Bupa Arabia
10m
2.5m
5
Bupa Arabia “7 Pillar Strategy”
 Enhance Our Proposition:
- Expand Distribution. To develop a multi-channel
strategy that ensures we are more easily accessible
1. Expand
Distribution
2. Reinforce
Our Service
Differentiation
3. Begin to
Establish
Healthcare
Leadership
Enhance Our Proposition
4. Better
Manage
Medical
Costs
Increase
Efficiency
- Reinforce our Service Advantages. To maintain lead
over competitors in customer service
- Establish Healthcare Leadership. To establish new
sources of differentiation, leveraging our healthcare
focus
 Increase Our Efficiency
5. Improve Branding
6. Work with Government to Improve Healthcare in KSA
7. Improve Organisational Capability and Capacity
Invest in Key Enablers
- Better Manage Medical Costs. To drive significant
improvements to medical costs and customer service
 Invest in Key Enablers
- Improve Branding. To increase branding activity to
support differentiation and growth.
- Improve Organisational Capability and Capacity. To
ensure we continue to have the right capability and
capacity to succeed.
- Increase Lobbying for More Effective Enforcement. To
continue working with government to address the most
pressing health issues in KSA
Bupa Arabia
6
KSA Health Insurance Industry: Innovation
• Without the ability to drive very
low pricing, many of the
industry’s smaller players (who
are not differentiated) have
begun to struggle
− Up Your Service Passion: step
change in service mindset and
excellence
− Breakthrough in healthcare
services
− Quality management systems
− An improved hospital experience
• We believe that having great
talent and an “amazing
culture” are critical to our
success. We strive to:
2006
• We are focused on moving
from “Health Insurer” to
“Healthcare Partner” through
innovativion:
2m
250k
2011
• Thanks to government
intervention that prevented
pricing health insurance below
risk cost, the extreme price
pressure in the private medical
insurance market abated from
the first quarter of 2013
8m
1.2m
2014
Bupa Arabia
10m
2.5m
Q1 2015
Saudi Health Insurance Market
Lives Covered
KSA Market Bupa Arabia
10m
2.7m
− Be leaders in all we do
− Create an innovative and caring
culture
− Be loved by customers
− Have amazing talent
− Consistently act according to our
values
Bupa Arabia
7
Bupa Arabia: Innovative Strategy
Bupa Arabia is the greatest healthcare company in the Arab world. It is designed to deliver on its
purpose. When it touches you, whether you are an employee, a customer or a community member,
you live a longer, healthier, happier life. We have written history.
A healthcare partner to
millions more people
Health insurance that leads the
market in unlocking access to highquality healthcare
Provision (e.g., clinics and
hospitals) sufficient to shift the
industry to a patient-centric,
outcomes-focussed paradigm
People love
working at Bupa because of our
amazing culture
Extraordinary business
performance
We are leaders in all we do
10 million total customers
We have an innovative and
caring culture
10 billion riyals in revenue
We are loved by customers
We have amazing talent
Partnerships to tackle the most
pressing healthcare needs
Bupa Arabia
We consistently act according
to our values
8
KSA Health Insurance Industry: The Future
• Regulatory change (or more firmly enforcing existing regulations) will lead to
dramatic improvements in the quality of care in Saudi Arabia
• This should include:
− Increasing provision (hospitals and clinics) capacity by allowing foreign and
health insurer ownership of provision
− Developing Public / Private Partnerships in provision, specifically outpatient
services, to bring private sector expertise and experience
− Better enforcing the existing mandate for private health insurance to
ensure there is no improper use of the public system
− Expanding the health insurance mandate to a broader spectrum of the
Saudi population, allowing them to access the quality of private provision and
allowing the government to increasingly focus on regulation, not healthcare
delivery
Bupa Arabia
9
Bupa Arabia Across the Phases
Bupa Arabia Lives and Premiums
Innovation
2750
6000
2500
Lives (k, LHS)
5000
2250
Market
Restructuring
Premiums (SAR m, RHS)
2000
4000
1500
Rush for Growth
3000
GWP
Lives
1750
1250
1000
2000
750
Pre-Enforcement
500
1000
250
Bupa Arabia
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
0
1998
0
10
Thank You
Bupa Arabia
11