In an exclusive interview, a BUSINESS LIFE reporter was eager to know more about TPAs and GlobeMed Group from the renowned expert, Mounir M. Kharma: Chairman and CEO of GlobeMed Group.
Mounir Kharma is the Chairman and Chief Executive Officer of GlobeMed Group. He holds an Engineering degree from the University of Oklahoma, USA and a Master Fellow of the Life Management Institute of Atlanta, Georgia, USA. He is also a member of Order of Engineers and Architects in Lebanon and member of International Federal of Health Plans (IFHP). He accumulated over forty years of international experience, with multi-disciplinary exposures and executive management positions. This includes several years as a member of divisional management team of the American Life Insurance Company (ALICO) (Now known as Metlife), and subsequently as Chief Executive Officer of MedNet Liban (GlobeMed Lebanon), before taking the stewardship of GlobeMed expansion.
An advocate of forward thinking and innovation, Mr. Kharma propelled GlobeMed to advance forward as leader in a competitive healthcare market to become a major provider of “Healthcare Benefits Management Services” (TPA). He was named as one of the most 50 influential personalities in MENA insurance industry.
BL: GlobeMed has been the leading healthcare benefits management company (TPA) in the region for nearly three decades. How was GlobeMed conceived and its operations commenced, similarly how would you describe its successful development over the past years?
Mounir Kharma: GlobeMed was established, under the MedNet Liban flag in 1991, as a company serving the health insurance needs of the Lebanese market. At the time, the country was coming out of a 15-year civil war and, like many other industries, the insurance sector was in need of a major overhaul, and needed help with building up a professional approach to services under the health insurance sector. MedNet Liban was born out of this need. As the first TPA in the country, providing elementary TPA services, we worked with different stakeholders to introduce professional actuarial practices, develop know how in respect to product design to meet market needs, underwriting, and rationalizing brokerage fees”. Most of all the role was to project professionalism at levels of dealing with insured patients, healthcare providers, and other stakeholders. The health insurance business rapidly developed through the establishment of good business practices. Also, by working, listening to and addressing the needs of the market. Many of the improvements we introduced then; including individual and family programs with Guaranteed Renewability (GR), eventually became standard market practices some 25 years later! Over the years, we introduced scores of market firsts from medical coding to online claims portals, paving the way for use of algorithms and automation of rules. Telemedicine, Telehealth and Pharmacy Benefits Management were another set of firsts by GlobeMed. These represent a small sample of new concepts we are proud of introducing over the years.
Today, GlobeMed operates throughout the MENA region and employs over 1,400 staff members. It proudly serves over 200 clients in the private and public sectors, such as the Ministry of Health and The General Organization for Social Insurance (GOSI) in KSA. Our list of clients includes insurance companies, mutual societies, self-funded schemes, and social schemes.
GlobeMed made major leaps and strides during the past decades, expanding its geographical presence to 12 countries including Lebanon, Syria, Jordan, Iraq, Palestine, Egypt, KSA, Qatar, Bahrain, UAE, Kuwait, and Nigeria. During the journey, we have redefined the healthcare benefits management approach, delivering high quality healthcare services to insured members and to our client risk carriers, at optimal cost. This is not to mention enhancing the overall experience of the insured patients.
Today, we continue to challenge ourselves to further innovate and excel, and to provide state-of-the-art programs, solutions, and systems for an enhanced customer experience including the most recent introduction of population health and wellness programs.
BL: Who is the founder of GlobeMed?
Mounir Kharma: GlobeMed was founded by three insurance companies that were suffering under the health insurance business in Lebanon back in the 1990s. At the time, the country was coming out of civil war and the social insurance program was practically in default, so they had to manage the social requirements of their clients, the employers, who needed social benefits cover for their employees; particularly health insurance.
Though the health insurance business progressed and expanded, however it was not properly controlled. This was time to join forces under a joint venture to create a structure that will better control the health benefits process from pricing, underwriting, claims control, etc.
BL: GlobeMed portfolio currently includes 12 markets. Are you planning on adding new markets to your portfolio?
Mounir Kharma: Seeking new business opportunities and markets is always on top of our agenda, however, we try to follow an organic growth strategy by entering markets that complement the services reach to our existing markets. By expanding into territories that some of our clients are already present in, we do provide them with the advantage of multiple locations and faces but with a single voice; offering similar processes, services, and visibility. This is the reason why we focused on the MENA region, where some of our clients, with regional operations have such needs. In line with this strategy, we are planning our next expansion to the Sultanate of Oman very soon in anticipation of the launching of the new mandatory health scheme. Several of our existing clients are already present there. Also, GlobeMed planned entry to Sudan market was prompted to help out with the introduction of Microinsurance programs through teleassurance.
Meanwhile, we are already leveraging our proprietary technology that captures GlobeMed developed capabilities and to offer our solution as either an integrated solution suite or as unbundled modules in support of clients’ systems.
Under this new business model that introduced GlobeMed as a solution vendor, we expanded our client base to insurers and payers that manage their portfolios on an in-house basis. Our best seller is the standalone Pharmacy Benefits Management (PBM) program. We also recently completed the deployment of our first system license to a fully-fledged TPA in Algeria. As a vendor, we already serve various clients in different countries and the list is expanding.
BL: In your opinion, what should be the role of TPA in this market?
Mounir Kharma: The role of a TPA is to conduct administration of claims processing and network management to insurance companies, self-funded and social security schemes. A TPA must demonstrate efficiency in processing claims, and to exercise effective monitoring and control over the claims life cycle. Meanwhile, the positive patient experience should always be kept as top priority of a TPA.
Accordingly, TPAs should provide comprehensive ongoing benefits management services to insured patients. In fact, TPAs should henceforth better focus on developing its role to seamlessly integrate the various stakeholders: insurers, healthcare providers, insured patients to serve their different needs, to the extent of better managing their health and wellness needs.
GlobeMed expanded its role to offer its clients supporting services to include actuarial services, product design, Software as a Service (SaaS), medical coding, PBM services (e.g. formularies, etc.), etc., allowing them not only to contain the cost but also to increase their sales and support their business expansions and strategies.
A TPA should have an essential role to play in the public sector to assist governmental entities to better manage the healthcare benefits sponsored or mandated by these entities.
The TPA business in the MENA region recorded success as a claims processor! New digital, technological advancement and automation of claims life cycle process and other services will certainly disrupt the traditional TPA approach especially with the advancement of medical and administration codes standardization, Interoperability, Artificial Intelligence, robotics, and automation that are overdue for a business transformation.
BL: What sets GlobeMed apart from other TPAs in the region?
Mounir Kharma: I believe that there are several aspects that distinguish GlobeMed from the rest of the crowd including
a. GlobeMed is committed to performance with consciousness towards all stakeholders under the health services chain, making sure that equitable practices are observed.
The health sector is unfortunately infested with multitudes of “wrongdoing” at its different layers. We are advocates of “fair play” between business partners and never at the expense of the insured patient.
b. Our understanding that we are in a rapidly changing world and there is a need to be futurists in our visions, goals and continuous improvement drives.
c. Developing upright professionals takes time, careful training and professional education. GlobeMed Academy team sees to it that the organization is provided with a large number of training material, and proficiency programs to work with the teams in the various Operations. All positions in the organization have mandatory certification programs to achieve. We invest heavily in our most valuable resources, our people.
d. GlobeMed has a professional and technical arm namely GlobeMed Solutions. This organization has highly qualified and specialized professionals. GlobeMed Solutions is a “factory of successful innovations” that drives continuous improvements, new service program development, etc.
e. GlobeMed Solutions also boasts experienced in-house ICT capabilities for the development and deployment of new systems. This aspect enables GlobeMed to present itself as a system vendor with an ever-increasing list of clients and installations.
f. GlobeMed business model allows for a rapid and flexible expansion into new territories and markets based on a franchising model that can bring in potential experience and local strategic partnerships for a successful disposition.
BL: In your opinion, what are the health insurance trends to watch for in 2020?
Mounir Kharma: The health insurance sector will continue to grow at a fast pace propelled by ever increasing public drives toward universal health and population awareness. This will be the case at most GCC countries. The struggling economies in some other markets will impose a drag against growth. Health insurers and health providers should adapt their programs and the offerings to better accommodate the changing market needs. This means modifying the health program benefits and imposing more controls over excessive utilization, fraud, waste, and abuse. It is essential for the health insurance sector in these economies to strictly avoid any attempt at cash flow underwriting! This could undermine the foundation of these companies, especially smaller risk carriers.
Investing in health and wellness programs for insured members will attract the more serious insurers in an effort to pre-empting costly sickness consequences. Population health and wellness should start becoming a standard offering by health insurers very soon.
Alternative delivery of healthcare will also find its way into the health sector such as Telehealth, a concept that was introduced by GlobeMed in the 1990s. Also more focus will be made on high risk and high cost patients within the population in an effort to optimize their cost of care.
BL: What is the main driver that motivates you to keep expanding and taking on new business ventures, and to grow your companies? Did your motives change over the years?
Mounir Kharma: I would say that my main drivers didn’t change much over the years. In the beginning, I insisted to sign up for a 6 months’ term only, as I knew of the big challenge ahead! Decades passed and the challenges embedded into healthcare servicing and management kept me pushing forward and plugging holes on the way. I’m very much tempted by challenges! The truth is I don’t remember many easy and serene periods during my many years of service. On the other hand, I don’t remember many instances of boredom.
My current challenge is to develop a competent succession team and to drive GlobeMed toward maintaining its visionary talents through the years ahead.
BL: What are your main goals and vision for the year ahead?
Mounir Kharma: God willing my main goals are to finalize development of a few power driving projects at GlobeMed that will sustain its professional leadership. Also, to support its ability to maintain the marketing surge it enjoys.
As for my personal goals, I’ll try and stay healthy to enjoy my retirement days at Ain Azimeh where Lebanon is at its best.
BL: Currently, Lebanon is passing through a crucial situation, how is it going to impact the business operations of GlobeMed and the rest of the sectors like the insurance sector and the economy?
Mounir Kharma: There are problems with the economy and the financial situation in the country. The market is definitely suffering and many employers are in difficulties, and those that are not as yet, intend to slow down payments. Clearly, risk has negative consequences on the insurance sector, particularly the health sector where there are significant and rapid settlements required with healthcare providers. To add to the problem of the hospitals and other providers, the public sector has several health programs most of which have significant outstanding amounts due to the sector. This is a critical situation as people have needs under the health sector, that treatment of most cannot be differed.
My optimism is that once we reach a resolution, we can begin focusing on rebuilding our economy and all other sectors, particularly the health sector for the good of our country.
