Universal Health Coverage National Observatory

Background: Health coverage is the payment or the reimbursement of patients’ healthcare costs under a health plan offered in connection with employment or a government program or a private insurance. In Lebanon, the public health guarantors for civilians are the NSSF, the MoPH (Ministry of Public Health) and the state employees’ cooperation. In 2017, Oummal hosted a workshop including all healthcare actors coming up with recommendations to enhance the health coverage in Lebanon. Some of the most important recommendations were: activating the coordination and cooperation committee between all the guarantors, setting a limit to the hospitalization fees, unifying the sources of import of medical supplies and equipment, submitting a bill for a contract to be done between the guarantors and the hospitals in a patient-centered approach, and unifying a hotline for all guarantors in order to have a maintained service for all patients from which resulted the UHC-ON.

The Universal Health Coverage National Observatory is a platform for patient financial and legal protection. Through the UHCON, Oummal plays the role of the mediator between the patients, the public guarantors and the healthcare providers. Oummal cares deeply about playing this role and ensuring that the patient enjoys his right to health while preserving her or his dignity without having to contact a political or a sectorial party.

The contact center of Oummal is the pillar of the UHC-ON activity. It has the UCM feature which is a progressive technology maximizing the efficiency and the effectivity of the calls handling. The contact center involves as well documentation programs designed and developed at Oummal to offer the best beneficiary service.

The project aims to receive, analyze and solve the patients’ grievances through the hotline #2424 (a low-cost name tag that is easy to memorize), to ensure the auditing of the hospitalization bills and to monitor and report breaches committed by the hospitals or the monitoring doctors to the public guarantors responsible to take appropriate actions. Consequently, Oummal would be able empower the patients through an approach based on them, to support the public institutions and to recommend adjustments to the national health coverage services and schemes.

The main guarantor cooperating with Oummal is the NSSF receiving biweekly reports of the calls, the patients’ cases, the hospitalization fees and the procedure and follow-ups details.

In December 2020, the COVID-19 hospitalization cases started arising, the UHC-ON started receiving complaints about the lack of hospital beds and the high hospitalization fees. To solve these issues, Oummal developed a dashboard for COVID beds available in the hospitals and shared with the operators of the UHC-ON and the NSSF, and as a preventive action that could help reduce the hospitalization risk altogether, Oummal decided to share its expertise in call centers by managing the contact center of the vaccination hotline.

From March 2020 till May 2022

2,325 Received Calls

2,184 Documented Calls 

1,661 Follow-ups

2,147 Solved calls

19 Patients received a refund from the hospitals (114,200,000 LBP = 76,133 USD)

Type of documented calls

1,575 Inquiries

543 Complaints

25 Calls for patients guaranteed by the MoPH (patient’s guarantor)

1,840 Calls for patients guaranteed by the NSSF (patient’s guarantor)

18 Calls for patients guaranteed by the state employees’ cooperation (patient’s guarantor)

Important dates

October 2019: Project initiation date

March 2020: The hotline #2424 was adopted by the NSSF (National Social Security Fund)

The UHC-ON is still operational till this date.

Partners

NSSF

Donors

Friedrich Ebert Stiftung

Budget

Total budget: 19,000 USD (exchange rate: 1 USD = 1,500 LBP)

This was a startup budget for setting the infrastructure of the contact center at Oummal.

Human resources

7 Volunteers and 2 Employees