health care transformed by the power of engagement or health, happiness and money: The three things that matter most Connecting Countries through Care Lex de Jong Chief Medical Officer UO AZV Green Aruba, where Europe meets the Americas

Overview Health, Money & Happiness What, Who, Why, Where & How Billion Dollar Offer

Health: introduction of AZV National Health Insurer of Aruba (since 2001) Coverage of curative care (hospital, primary care, medication, dental, etc) All residents of Aruba ( ) Growing demand on health care due to aging population growth increase in lifestyle diseases Life expectancy has increased by 4 years since the implementation of AZV Policy focuses on sutainability of the system => quality of care

sustainability focussed policy explained Q- Q+ Q0 Q- Q+Q+ Q0 Guide lines Best practices Policy Q ++

Money: towards stability *Costs are not corrected for inflation year Expenditures( in million*) costs* per person (in USD) CountryArubaCuraçaoNetherlands Cure & Care in GDP11%14%13% Cure costs* per person (AWG)

Happiness: great results! Costs have never been this low Quality has never been this high Proces of logistics and billing has never been better *Costs are not corrected for inflation 2010: no reliable data

What, Who, Why, Where, When & How

What is the problem? World wide issue: increasing demand for health care due to aging, life style diseases, increasing medical technology, wasteful spending, economic situation Regional issue: not all demand can be delivered locally (economies of scale), preventive care and compliance are still on a low level Aruban issue (until 2011): when sending out patients abroad, they entered a ‘black box’ where were they treated when did they come back how much does it cost have we received all the bills is the billing done according to standards difficult doctor to doctor communication

Who are part of the solution USA en Europe Top knowledge institutions Setting out to establish world wide network Upcoming countries like Colombia, Brasil Investing in health care New top hospitals linked to USA and EU Lower overall costs and more competitive pricing Aruba Innovative way of setting up relationships Multi cultural en lingual country You?

How did we solve it? Sticking to our goals (transparancy, logistics, billing, costs) Find good partner (OES) to help select proven quality (4 hospitals) Communicate, communicate, communicate: Personal, one on one be very much aware of the cultural differences, explain be fair, trustworthy No rushing Upgrade in IT for logistics, used by both sides Own logistics department with us and the hospitals

Why do we do it? Health care is an opportunity to connect to others, to invest and improve For Aruba: Investing in local health care that can help others in the region (cochlear implants, sharing hospital facilities, cardiology pilot, oncology plans) Improving health care abroad: matching demand to high end supply in the region through excellent IT-tools and smooth logistics Our results: Shift to top end hospitals, highest ranking in Colombia From yearly raise in tariffs of 4%, to stable and decreasing rates Stable relationship, better doctor to doctor communication Major improvement in logistics and reliable billing

Why do our partners participate? Partner hospitals in Colombia Complex patients are needed to continue the development as high end hospital Incentive to achieve and maintain international quality accreditation Compliant with national policy to make medical tourism a new economic pillar Practice makes perfect Economic reasons and different relationship than with local insurers OES: Extra insight in Colombian hospitals Structural addition to own portfolio International networking

Why will more value be added? Health care in Latin America will continue to improve From long term relationship comes willingness to invest in local Aruba health care Sharing knowledge and experience, showcase the Aruba model Guaranteed inflow of the high complex patient. High end university hospitals in USA and Europe have taken an interest already: Erasmus MC (#1 hospital in the Netherlands) will be our preferred hospital in the Netherlands UPMC (Pittsburg, USA) and FCV (Bucaramanga, Colombia) are teaming up to provide extra services and quality for the Aruban patient

Where else is this model beneficial? All countries that have to send out patients and feel they are not in control When dealing with different cultures and different systems For organizations that are looking to improve their health care contracting Logistics Networking Quality to costs ratio

When can you begin? NOW

Billion dollar offer We aim to do this for and with other countries as well. No charity: More volume means better logistics and lower prices Start of more cooperation Consider the possibilities See the chances these developments bring Let’s change how health care is organized right now.

Thank you