Transcript Teona TETELOSHVILI

Health Insurance System In Georgia
Teona Teteloshvili
Aldagi BCI
June 2013
EXECUTIVE SUMMARY
1
GEORGIAN ECONOMY TODAY
2
INSURANCE MARKET IN GEORGIA
3
ALDAGI BCI - INSURANCE MARKET
LEADER
4
FEDERAL/STATE HEALTH INSURANCE PROGRAMS
5
FEDERAL/STATE HEALTH INSURANCE PROGRAMS
AND THEIR INFLUENCE ON INSURANCE COMPANY
BUSINESS
6
FUTURE OF THE HEALTH INSURANCE IN GEORGIA
2
GEORGIAN ECONOMY TODAY
33
2012 Estimated Real GDP Growth Rate for the Selected
Countries *
*Source: IMF, World
Economic Outlook (2012
April data)
Geogia Key Economic Data
Nominal GDP (GEL mln)
Real GDP Growth (y-o-y; %)
GDP per Capita (US$)
CPI (e-o-p; %)
Net FDI (US$ mln)
Current Account Deficit as % of GDP
2005
11,621
9.6%
1,484
6.2%
542
-11.1%
2006
13,790
9.4%
1,763
8.8%
1,186
-15.1%
2007
16,994
12.3%
2,315
11.0%
1,675
-19.8%
2008
19,075
2.3%
2,921
5.5%
1,523
-22.8%
2009
17,986
-3.8%
2,455
3.0%
658
-10.7%
2010
20,734
6.3%
2,623
11.2%
815
-10.3%
2011E
24,229
7.0%
3,215
2.0%
984
-11.7%
INSURANCE MARKET IN GEORGIA
DENSITY & PENETRATION
•
•
PENETRATION
(GPW/GDP)
Y2009
INSURANCE DENSITY
(GPW PER CAPITA USD) Y2009
Nascent state of
Georgian insurance
sector translates into
extremely low insurance
penetration and density
levels
Market research reports
reveal that majority of
population does not
have adequate
perception of property &
personal risks, thus is
reluctant to pay money
for risk minimization
EXCLUDING GOVERNMENTAL
PROJECTS IN GEORGIA :
DENSITY
USD 22.4
PENETRATION
0.9%
UK
4,579
UK
12.9%
France
4,269
France
10.3%
US
3,710
US
8.0%
Germany
2,878
Italy
7.8%
Italy
2,729
Germany
7.0%
Czech Rep.
649
India
5.2%
Poland
403
Czech Rep.
3.9%
Estonia
357
Poland
Russia
281
China
3.4%
C&E EUROPE
263
Brazil
3.1%
Brazil
252
C&E EUROPE
2.7%
Latvia
182
Estonia
2.7%
Lithuania
168
Russia
2.5%
China
121
* GEORGIA*
Turkey
103
Latvia
1.7%
4%
1.9%
India
54
Lithuania
1.7%
* GEORGIA
47
Turkey
1.3%
*Figures for Georgia Include
Governmental Projects
44
SOURCE 1: Swiss Re sigma study “World insurance in 2009”
SOURCE 2: CEA Statistics N°42, “European Insurance in
Figures”
INSURANCE MARKET IN GEORGIA
PREMIUMS
BY YEAR & MARKET SHARE OF INSURANCE
IN GEORGIA
COMPANIES
INSURANCE MARKET
55
(9 months)
GROSS WRITTEN PREMIUM
AMOUNTS IN '000 GEL
14 INSURANCE COMPANIES ON THE
MARKET
5 LARGEST INSURANCE COMPANIES
HOLD MORE THAN
79% OF THE MARKET
SOURCE: NBG – National Bank of Georgia
INSURANCE
COMPANIES BY GPW,
9 MONTHS 2012
Y-o-Y
GROW
TH
74.9%
30%
GEORGIAN INSURANCE MARKET
BY PRODUCT ANALYSES
Y-o-Y
+106.9%
Y-o-Y
+3%
SOURCE: NBG – National Bank of Georgia
66
HEALTH CARE MARKET IN GEORGIA
TOTAL HEALTH CARE EXPENDITURES
CIS COUNTRIES COMPARISON Y2009
SOURCE: WHO.
World Health
Statistics 2010
Georgia has
one of the
highest rate
of Health Care
expenditure
as % of GDP,
among other
low income
countries
Armenia
Azerbaijan
Belarus
77
Per capita
Total
Government
expenditure on expenditure expenditure on
health (US$) on health as % health as % of
of GDP
total Health
expenditure
GEORGIA
Kazakhstan
Kyrgyzstan
Moldova
Russia
Tajikistan
Turkmenistan
Ukraine
Uzbekistan
133
140
302
191
253
46
127
493
29
139
210
41
4
4
7
8
4
7
10
5
5
3
7
5
47
27
75
18
66
54
51
64
22
52
58
46
CIS AVERAGE
175
6
48
EU-12
AVERAGE
1379
7
72
EU15
AVERAGE
4134
9
78
On the other
hand, the share
of Governmental
expenditure in
total Health Care
sector is the
lowest in
Georgia among
European
countries
ALDAGI BCI – THE LEADER ON THE INSURANCE MARKET
88
BRIEF INFO ABOUT ALDAGI BCI
ALDAGI BCI KEY DATES
o
FIRST INSURANCE COMPANY ON
THE MARKET – SINCE 1990
2012
ACQUISITION OF INSURANCE
COMPANY IMEDI L
ACQUISITION OF INSURANCE COMP. PARTNER
2011
o
o
VENTURE OF 6 INSURANCE
COMPANIES
2010
WIDEST DISTRIBUTION CHANNEL
ACQUISITION OF BLOCK GEORGIA ASSETS
ABCI - MEMBER OF BANK OF
GEORGIA GROUP
2009
o
UNDISPUTED LEADER ON THE
MARKET*
o
By Revenue – 32% Market Share
o
By U/W Profit – 45% Market Share
o
By ASSETS – 37% Market Share
* Figures for 9 months of 2012
2008
2007
ALDAGI BCI ENTERS INTO
HEALTH CARE BUSINESS
2006
ACQUISITION OF
ALDAGI BY BCI
2005
ACQUISITION OF EUROPACE BY
BCI
ACQUISITION OF SALBI BY ALDAGI
2004
ACQUISITION OF BCI
BY BANK OF GEORGIA
ALDAGI BCI – THE LEADER ON THE INSURANCE MARKET
99
INTEGRATED BUSINESS MODEL
INSURANCE
o
o
o
o
o
o
o
Market leading life and non-life
insurance provider. 9 months of
2012 market shares of 30%
Gross Premiums Written; 32%
by Revenue
More than 607,000 corporate &
retail clients;
HEALTHCARE
o
o
o
Widest distribution channel
99% of brand recognition
o
Largest insurer of property &
casualty risk
Largest Banc assurance network
in the country
Capable management team with
strong acquisition & integration
track record
o
o
The first managed healthcare
provider since 2006
The largest managed chain of
clinics
A chain of 26 hospitals with a
concentration in Western
Georgia, covering approximately
40% of Georgia’s population
40% of ABCI claims expense
become revenue of its own
healthcare business
Gross Profit Margin 40.6%
EBITDA Margin 22.4%
ALDAGI BCI – THE LEADER ON THE INSURANCE MARKET
ALDAGI BCI BUSINESS DEVELOPMENT DYNAMICS
10
ALDAGI BCI TRENDS BY LINES
GROSS WRITTEN PREMIUM
AMOUNTS IN '000 GEL (1.62 GEL ~ 1 USD)
(3 Quarters of 2012 and 2011)
SOURCE: NBG – National Bank of Georgia
ALDAGI BCI – THE LEADER ON THE INSURANCE MARKET
1 11
1
ALDAGI BCI IN HEALTHCARE INDUSTRY
ABCI HEALTH CARE CHAIN – IS THE
LARGEST IN THE COUNTRY
o Till 2010 Operated with 5 small
outpatient Clinics
26 HOSPITALS
o IN 2010 Invested 15 mln USD in
Building 5 small sized and 1 middle
sized hospitals
AS A
RESULT
o ABCI ENTERED INTO HEALTH CARE
BUSINESS IN 2006
1,120 BEDS
80% OF THE MARKET SHARE IN
WESTERN GEORGIA
o In YE 2011 acquired Hospital Assets -11
Operating hospitals - from the largest
health care Company
COVERED POPULATION – 1,800,000
110,567
IN 2012 By Acquisition
of Imedi L, ABCI added
to its hospital Chain 6
67,314
6,215
7,204
New Hospitals and 4
Under construction
* includes 4 small outpatient clinics
12,550
FEDERAL/STATE HEALTH INSURANCE PROGRAMS
HISTORY
o In 1992 year free of charge healthcare system was abolished and
till 1995 year was only out of pocket payment, what caused
increase of morbidity, mortality
o In 1995 year Insurance Fund was created. From Insurance
Fund was covering only:
• Socially Dangerous Diseases – tuberculosis, HIV etc.
• Children from 0 till 1 years of age
• Pregnancy Monitoring
• Urgent hospitalization and treatment of Veterans and
Socially Unprotected People
BUT, funds were insufficient and recourses were enough only for 20%
of medical cases
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2
FEDERAL/STATE HEALTH INSURANCE PROGRAMS
1 13
3
HISTORY
In 2007 State Insurance Pilot program was launched which covered
only People Under the Poverty Line. This program is operating till
now but with some corrections.
o
•
•
•
•
WAS:
State was in the role of Insurer
Any Insurance company has
right to take part in this project
Beneficiaries were granted with
Insurance Vouchers and they
have ability to choose in which
Insurance Company they want to
be Insured
o
•
•
•
Number of Insured In 2007 year 196 000
•
NOW:
State is in the role of Insurer
Any Insurance Company has
right to take part in this tender
and choose region where he
wants to operate
Country was divided into 26
conditional
regions
and
Beneficiaries were obligated to
choose
concrete
Insurance
Company which won tender in
concrete region
Number of Insured – 806 066
FEDERAL/STATE HEALTH INSURANCE PROGRAMS
1 14
4
HISTORY
From 2007 simultaneously with State Insurance for People Under
the Poverty Line were launched other projects, where State was in
the role of Insurer also.
o Teachers State Program
o Tbilisi City hall Program
o Vulnerable Children
Program
o Refugees State program
o “Cheap Insurance”
Also, for people who were not eligible for above mentioned programs,
State has special programs, which covered Oncology diseases, Infectious
Diseases and etc.
In 2008 nongovernmental Health Insurance Mediation Institute was
launched. Role of this institute was to help beneficiaries arrange relation
with Insurance Companies
FEDERAL/STATE HEALTH INSURANCE PROGRAMS
HISTORY
1 15
5
In September, 2012 State launched second global program for
Children and pension age adults.
•
•
•
•
•
State is in the role of Insurer also
In the range of this program were Insured: Children from 0 till 6 year of age
and pension age people - Women from 60 years of age and Men from 65 years
of age
Any Insurance Company has right to take part in this tender and choose
region where he wants to operate
Country was divided into 26 conditional regions and Beneficiaries were
obligated to choose concrete Insurance Company which won tender in
concrete region
Number of Insured: Children – 251 600, Pension age – 546 996
After this project was launched all other programs were cancelled,
except Tbilisi City Hall program and Under the Poverty line program
FEDERAL/STATE HEALTH INSURANCE PROGRAMS
1 16
6
Coverage
Both State insurance Programs Cover the same list of Services
•
•
•
•
•
•
Urgent Ambulatory Fully
Urgent Hospital Service Fully
Planned hospital service, Oncology and
Cardiology
Planned Ambulatory service with very limited list
of services
Medicines with very limited list
Delivery (only for Under the Poverty Line
Program)
FEDERAL/STATE HEALTH INSURANCE PROGRAMS
GENERAL HEALTH INSURANCE PROGRAM
1 17
7
In March, 2013 State launched third global Project “General Health
Insurance Program”.
•
•
•
•
In the range of this program were Insured people who where not eligible for other State
Projects and who do not have private Insurance policy.
Beneficiaries should apply service centers and take policy
Insurance Companies are not involved in this project, State has direct calculation with
Hospitals. Insurance companies are only obliged to send monthly renewed policyholders
data base.
“General Health Insurance Program” covers only Urgent Ambulatory and Hospital
Services
FEDERAL/STATE HEALTH INSURANCE PROGRAMS
INFLUENCE ON INSURANCE COMPANY
Under the Poverty Line
Program
•
•
•
•
•
SHOCK caused by Significant
Increase of health insured
number
Necessity of new service centers
and units what caused increase
of administration costs
Expansion of Providers network
Obligation of involvement In
healthcare system
No impact on Insurance Company
Corporate and Retail Business
business
1 18
8
Children and Pension Age
Adults Program
•
•
•
•
•
Already ready for Increased number of
Health Insured Number
NO Necessity of new service centers and
units
Already Expanded Providers network
Already involved In healthcare system
Insignificant impact on Insurance
Company Corporate and Retail Business
business
FEDERAL/STATE HEALTH INSURANCE PROGRAMS
INFLUENCE ON INSURANCE COMPANY
General Health Insurance Program
•
•
•
Does not decrease number of insured because it covered only people who
where not eligible for other State Program and who do not have private
Insurance policy.
Insurance Company itself is not involved in this program, but this program
increase revenue of our second business, healthcare system
Does not decrease number of insured because it covered only Urgent
Ambulatory and Hospital Services
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9
FEDERAL/STATE HEALTH INSURANCE PROGRAMS
2 20
0
State Insurance Policyholders Number and Total
Number of Policyholders in Georgia
60.0%
50.8%
50.0%
40.0%
23.2%
30.0%
17.1%
6.0%
20.0%
10.0%
29.9%
20.6%
33.8%
20.3%
32.4% 37.9%
20.2%
4.1%
0.0%
2007
2008
2009
2010
2011
2012
Number of State Insurance
policyholders
FUTURE OF THE HEALTH INSURANCE IN GEORGIA
•
•
•
•
2 21
1
As we see, in Georgia we do not have Mandatory Health Insurance, we have
only Federal/State programs covering definite groups of people.
As we know changes are planned, but it is not yet known what projects will be
launched.
Insurance Companies will be involved or not in this projects.
Existed programs will continue or not
BUT
As the leading company of the Georgia’s Insurance market, Aldagi
BCI is ready for challenges and we are sure , we will deal with them
and adapt quickly.
THANK YOU FOR YOUR ATTENTION
TIME FOR QUESTIONS & ANSWERS