DIGITAL REVOLUTION AND UNIVERSALIZATION OF AMO: THE MOROCCAN MODEL
The generalization of Compulsory Health Insurance (AMO) in Morocco represents one of the most ambitious social reforms of recent decades. Two years after the implementation of this major transformation, it is time for evaluation.
To analyze these challenges, La Vie Éco brought together key players in the national healthcare system during its conference series “Les Débats de La Vie Éco,” under the theme: Two Years After the Generalization of AMO. Participants included Hassan Boubrik, Director General of the CNSS (National Social Security Fund), Abdelkrim Meziane, Secretary General of the Ministry of Health, Rochdi Talbi, CEO of the Akdital Group, Raouf Mohsine, Director of the Ibn Sina Hospital Center in Rabat, and Yasser Sefiani, Professor of Medicine and Clinic Director.
During his speech, Hassan Boubrik highlighted the reforms implemented at the CNSS, combining digitalization and enhanced accessibility. What are the real impacts of this transformation? What challenges remain to be overcome? Here’s an in-depth analysis.
A RAPIDLY EXPANDING HEALTHCARE COVERAGE
Morocco has tripled the number of AMO beneficiaries in just a few years. From 7.8 million insured individuals in 2020, the country now covers 25 million people under the CNSS. This progress was made possible by the massive integration of self-employed workers and the inclusion of former RAMED beneficiaries into the AMO-Tadamon scheme. December 1, 2021, marked a historic milestone with the immediate integration of 4 million new insured individuals, followed by the transition of RAMED to AMO Tadamoune, covering 11 million additional beneficiaries.
The CNSS now processes over 110,000 reimbursement claims per day, compared to 22,000 in 2020—a dramatic increase that illustrates the scale of this undertaking.
DIGITALIZATION: THE END OF PAPER MEDICAL FORMS
The shift to digital is at the heart of AMO’s transformation. Within 12 months, the CNSS plans to gradually replace paper medical forms with a digital version. To achieve this, it will be essential to deploy this system among doctors and healthcare providers while placing the patient at the center of this transition. Of course, this evolution will take time. The system relies on several key innovations:
- Digital patient identification: No need for physical documents; everything is recorded on the CNSS portal by the doctor.
- Integrated prescriptions and reimbursements: Medications, lab tests, and imaging will be directly recorded and accessible to healthcare professionals.
- Reduced reimbursement delays: Currently estimated at 8 to 9 days on average, these delays are expected to decrease further with automation.
“I hope that within 9 to 12 months, things will be concrete. Our platform will be deployed on a pilot site before a nationwide rollout,” said Mr. Boubrik during the La Vie Éco conference. The project is being carried out in collaboration with Brom, a digital transformation specialist, according to LeDesk.
ENHANCED ACCESS ACROSS THE COUNTRY
The expansion of AMO required a restructuring of the CNSS’s territorial network. Faced with the urban concentration of infrastructure, the CNSS has:
- Expanded its network from 120 to 174 agencies,
- Partnered with payment institutions, bringing the total number of service points to over 3,000.
Today, 93% of requests are processed through these decentralized channels, reducing average wait times at agencies to just 10 minutes, according to Mr. Boubrik.
THE CASE OF THE “8 MILLION EXCLUDED”: REALITY OR MISINTERPRETATION?
A debate persists around the 8 million Moroccans supposedly not covered by AMO. Hassan Boubrik nuances this figure: these individuals are not excluded but rather have not yet registered or have stopped contributing.
“We have established a system where the state covers the contributions of the most vulnerable through AMO-Tadamon. However, those who can afford it must contribute to benefit from the coverage,” explained Hassan Boubrik.
FUTURE CHALLENGES: SUSTAINABILITY AND INTEGRATION OF THE SHARED PATIENT RECORD
While AMO now covers nearly 25 million Moroccans under various schemes (CNSS, CNOPS, etc.), the question of its financial sustainability remains. A revision of the National Reference Pricing (TNR) is underway to improve healthcare accessibility. For example, if the TNR for consultations is adjusted to address gaps, it could facilitate spending but risk negatively impacting the system’s balance.
Another sticking point is coordination with the Ministry of Health’s Shared Medical Record (DMP). This project, which aimed to centralize all patient medical information, was suspended by the ministry’s new leadership, raising concerns about the interoperability of healthcare systems.
A MODEL TO FOLLOW FOR AFRICA?
The Moroccan case offers valuable lessons for healthcare decision-makers in Africa. The massive integration of new insured individuals, combined with rapid digitalization, demonstrates that universal coverage can be achieved by optimizing administrative and technological management.
The question remains whether Morocco can maintain its momentum while ensuring the financial sustainability of its healthcare system. The generalization of AMO represents a major step forward, but two challenges persist: first, ensuring effective coverage for all populations, regardless of their circumstances; and second, guaranteeing sustainable funding that meets the growing needs of the system.
