Managed Care in Saudi Arabia

Authors: Mohammed Hassan Alharbi, Marwah A. Alharbi

DOI: https://doi.org/10.5281/zenodo.13970722

Short DOI: https://doi.org/g8nq93

Country: Saudi Arabia

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Abstract: Managed care has transformed healthcare delivery systems globally, including in Saudi Arabia, where it is influenced by the Compulsory Employment-Based Health Insurance (CEBHI). This paper explores the integration and impact of managed care within the Saudi Arabian healthcare system, which includes government, semi-governmental, and private sector providers. The study delves into the structure and types of managed care plans available in Saudi Arabia, such as Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), Exclusive Provider Organizations (EPO), and Point of Service (POS) plans. It evaluates the advantages of managed care, including cost reduction, enhanced preventive services, and improved access to healthcare for the insured population. However, it also identifies key disadvantages, such as potential declines in care quality, restricted access to specialists, and issues affecting the doctor-patient relationship. The paper also assesses the effects of managed care on various healthcare specialties and compares the Saudi experience with managed care systems in other countries, particularly the United States. The findings underscore the dual nature of managed care, highlighting both its potential to enhance efficiency and its risks to quality and accessibility. Recommendations are provided to address these challenges and improve managed care outcomes in Saudi Arabia.

Keywords: -

Paper Id: 231408

Published On: 2020-04-07

Published In: Volume 8, Issue 2, March-April 2020

Cite This: Managed Care in Saudi Arabia - Mohammed Hassan Alharbi, Marwah A. Alharbi - IJIRMPS Volume 8, Issue 2, March-April 2020. DOI 10.5281/zenodo.13970722

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