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  • October 30, 2017

How the Chilean Public Health System Uses Oracle Technology to Modernize Healthcare

Millie Lapidario
Product Marketing Analyst

When more than 13 million people rely on a public healthcare system, delinquent participants can lead to grave consequences. The Chilean national health system is cracking down on debtors with help from Oracle’s healthcare technology.

Fonasa is the financial entity in Chile responsible for collecting, administering, and distributing state money for healthcare. The majority of Fonasa’s beneficiaries are responsible for contributing 7 percent of their monthly income to fund public health insurance.

Recently, Fonasa discovered an alarming situation: about 50,000 private and public employers had failed to pay their contributions. From February 2016 to August 2017, those debts rose to 32 billion Chilean pesos (more than 51 million USD).

Healthcare Technology to the Rescue

Fonasa is turning up the heat on noncompliant employers. Chilean President Michelle Bachelet recently announced that Fonasa’s new IT system will help the agency detect missing payments and improve the entire process of collecting monthly funds.

Photo credit: Chatham House, distributed under a CC-BY 2.0 license

Photo credit: Chatham House, distributed under a CC-BY 2.0 license

To solve its collection problems, Fonasa modernized its IT system. The health insurer chose the same healthcare technology that more than 100 leading payers choose for digital insurance transformation: Oracle's solution for healthcare payers. Oracle’s solution now automates Fonasa’s monthly collections process and monitors payments closely. When an employer fails to pay, Fonasa becomes aware of the problem. Fonasa will also make it easier for employers to submit their payments online.

In a translated news article from La Tercera, President Bachelet said the objective was “to regularize the gaps and social security debts of millions of affiliates in our country.”

In cases where the employer fails to submit a monthly payment, Fonasa will email the company and publish the name the of delinquent employer in the Labor Bulletin of the Labor Directorate. From there, the employer will either pay or seek clarification. And if the employer still does not pay, the situation will escalate to the courts.

 

A 24/7 Watchdog to Protect and Manage Chile’s Healthcare System

Because Oracle's healthcare solution is benchmarked to support 100 million policies, the IT system can easily support the growing population in Chile. Oracle’s solution helps insurers manage sales, underwriting, contracts, claims processing, policy processing, and every insurance-related step from a central platform.

For Fonasa in particular, Oracle's healthcare solution provides the much-needed technology to rein in on financial deficits in real time. The system, equipped with straight-through processing, serves as a 24/7 watchdog for the Chilean health system.

Oracle's solution plays a vital role in Fonasa's digital transformation efforts. Now that the Chilean health system is well equipped to rebuild and protect its financial resources, the payer can focus on administering healthcare to its 13 million-plus members. 

To learn more about Oracle's solutions that provide the modern, rules-driven flexibility insurers need, visit oracle.com/insurance.

 

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