An Overview of Southeast Asian Healthcare Delivery
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As we emerge from COVID-19, there are likely to be major changes in the way primary medical care and other aspects of healthcare delivery are provided in Southeast Asia.
To understand where we are going, it is best to have a good understanding of the today’s conditions in Malaysia, Thailand, and the Philippines, where the current landscape is similar and participants anticipate the arrival of some form of universal healthcare coverage, as well as in Singapore, which already provides universal health coverage.
Regionally, four giants dominate the market of key insurers providing HMO-like benefits to their policyholders. They are Manulife; AIA, operating under Philam Life; AXA; and Sun Life Financial.
In the Philippines, there also are four major standalone health maintenance organizations: Intellicare, Maxicare, MediCard, and PhilCare. These HMOs generally have one of three primary care operating models. Some operate as in-house clinics for medium and large companies, supplying health personnel and running health and wellness programs for employees. Others partner with a primary care provider, with the HMO providing additional services. The third and newer model, viable in areas where there is a concentration of potential users, is the HMO-owned primary care clinic.
Finally, there are companies that run primary and multispecialty clinics. My company, MyHealth, focuses on ambulatory surgical primary care clinics. Medical City, run by ProSer Health Services, and MegaClinic, an ambulatory surgical clinic owned by Metro Sanitas, have joined Metro Pacific and Keralty. And, finally, there is Healthway, part of Ayala Health Corporation, which is the only diagnostic clinic with an integrated pharmacy, offering seven multispecialty clinics and about 80 family clinics.
Basically, all the ambulatory surgical clinics offer the same services: primary care, diagnostic services, rehabilitation, outpatient surgeries, annual health checks, pre-employment physicals, and executive checkups. Apart from Healthway, which combines a pharmacy with care, what is available currently is an unintegrated system of hospitals, specialists, pharmacies, and laboratories. The absence of integration, therefore, results in the need for referrals, which currently is not seamless.
Current conditions are likely to change as a result of the pandemic, particularly as a result of the greater acceptance of digital tools and alternative access to healthcare. Several foreign companies have expanded their operations to the Philippines in the past year, for example, to capitalize on this trend.
Practo, which operates in India, Indonesia, and Singapore, entered the Philippines with electronic medical record services. It now also offers telemedicine. Zennya, based in California, offers a mobile app that initially provided users with access to services including massages and housecleaning. It has expanded into healthcare, providing telemedicine and allowing users to order prescriptions and lab tests. Medgate, based in Switzerland and operating in the Middle East, Australia, and India, has expanded greatly in the Philippine market. It is now one of the nation’s most robust telemedicine health providers, partnering with several companies and multispecialty clinics. Doctor Anywhere, already strong in Singapore, Vietnam, Thailand, and Malaysia, also has expanded in the Philippines.
I believe that the immediate future offers vast opportunities in several areas. One is in health information. Another is a huge need for an integrated service that would combine primary care clinics with HMOs and hospitals. And while there are many players that offer primary care services, there is still not a focus on the patient experience. That means there are opportunities for providers offering more bespoke services to serve private companies and individuals who are willing and able to pay out of pocket.
There also are opportunities as we move from the current curative model to more of a preventive and rehabilitative approach. Fortunately, preventive care through the general practice and primary care model is gaining popularity and effectiveness, and that’s driving down healthcare costs. But there is still generally low public awareness of primary care clinics and HMO benefits unless someone receives those benefits through their employer. The information as well as services that a new group of competitors can offer will serve to expand and improve the Southeast Asian market.
About Hernando Lorenzo
Dr. Hernando Lorenzo specializes in occupational medicine (a specialization most active in the field of preventive medicine, primary care, and management of injury or disability in the workplace). He is an accredited Occupational Health Practitioner by the Philippine Department of Labor and Employment with 17 years of experience in clinic management and health and safety administration. He was the Chief Operating Officer of MyHealth Clinic from August 2019 to August 2020. Hernando also held the position of Director, Medical Services, while working at TTEC Holdings, Inc. Before this, Hernando held the position of Medical Director for Medical Services, while working at International SOS Pte Ltd. Prior to this, Hernando held the position of Quality Assurance and Training Auditor, while working at International SOS Pte Ltd.
This healthcare article is adapted from the February 8, 2021, GLG Remote Roundtable “Primary Care and HMO in Southeast Asia.” If you would like access to this teleconference or would like to speak with healthcare expert Hernando Lorenzo, or any of our more than 900,000 industry experts, contact us.
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