المملكة: "Health insurance" It adopts a 90-day plan to evaluate and classify hospitals before renewal

Reveal The Health Insurance Council announced a new oversight mechanism that includes a comprehensive evaluation trip for health care service providers, aiming to measure the institutions’ compliance with quality and efficiency standards within the “Daman” program, within a time frame that begins three months before the date of renewing the facility’s official accreditation.

This step aims to move the level of medical services from traditional procedures to adopting value-based care models, to ensure that beneficiaries receive health services that match international standards and are characterized by transparency and sustainability.

The Council divided the evaluation trip into three precise time stations, beginning its first month by requiring facilities to appoint an “Assurance Ambassador,” who is the facility’s CEO who is responsible for leading and direct supervision of the self-evaluation processes and submitting compliance documents with the system.

In its second month, the trip turns from office procedures to the field, where the Council’s assessors carry out scheduled inspection visits to health facilities according to strict methodologies, which issue detailed reports that reveal the strengths and shortcomings in technical and administrative performance.
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The third and final month witnesses the decisive phase, as the Council issues its final classification of the facility based on previous data, accompanied by binding corrective plans to address the observations observed before approving the renewal of accreditation.

The Council linked the success of this trip to the interaction of the “Daman Ambassador” in raising Supporting documentsthat prove the closing of observations and the implementation of treatment plans, which puts hospital administrations directly responsible for improving their performance.

This integrated system comes to reflect the health sector’s trend towards precise governance, where accreditation is not limited to merely renewing licenses, but rather goes beyond it to be a certificate of entitlement based on the competence and quality of the medical outputs provided to the patient.