DR1 Daily News - Dominican Republic

The Superintendencia de Salud y Riesgos Laborales (Sisalril) in the Dominican Republic has introduced a groundbreaking proposal: a differentiated per capita model for health management plans. This new scheme aims to allocate resources to Administradoras de Riesgos de Salud (ARS), the local health plan managers, based on the risk level of their affiliates, a significant departure from the current uniform payment system.

As reported in El Dia, for years, a known but largely unaddressed flaw in the healthcare system allowed some ARS to prioritize financial gain over comprehensive care. These entities strategically enrolled low-risk individuals, primarily young, healthy men, who seldom required medical services. This practice effectively shifted the burden of higher-risk individuals—such as women of reproductive age and those over 60, who frequently require medical...