By Prashant Jhaveri, Head, Products and Strategy, Medi Assist
The Union Budget 2016 sets the tone for what we believe will redefine the future of the health benefits industry. Just as envisaged, the slew of policies aimed at ensuring financial inclusion will provide impetus to cashless benefits administration across the nation.
The new health protection scheme that offers health cover of up to INR 1 lakh per family and a top-up of INR 30,000/- for senior citizens will provide economic security through insurance policy-backed coverage, which in turn will result in cashless utilization of healthcare benefits. Health benefits administrators, with their ability to provide access to a wide network of empanelled hospitals and also manage claims in a cashless and paperless format, will be critical to the success of this scheme.
The Jan Aushadhi Yojana scheme to provide generic drugs at affordable prices is a precursor to where our nation is headed in terms of providing coverage for in-patient treatment, out-patient care as well as pharmacy benefits. TPAs will have a very significant role to play in ensuring smooth and cashless delivery of health benefits across the illness to wellness spectrum.
The National Dialysis Service program is another significant development. Apart from underlining the acute need for recurring medical care for management of chronic conditions, this also highlights the importance of prudently planning a hospitalization in advance. Patients can benefit enormously by planning an eCashless™ hospitalization that not only allows them to completely eliminate wait time during admission for a cashless treatment but also gives them full visibility into their expected cost of treatment.
Managing health benefits for a large, diverse and populous country like India is no easy task. Technology must necessarily be at the heart of any initiative to administer such significant public healthcare schemes. Biometrics-based e-cards for beneficiaries, paperless admission and claims management at network hospitals, SMS- and mobile app-based claims tracking for beneficiaries, integration with government systems for utilization tracking and MIS reporting, data analytics that empower government decision makers to derive intelligent insights from the enormous amounts of data collected from across the nation; health benefits administrators cannot reach their true potential by merely processing claims. We must morph into technology and implementation partners for the Government and take cashless benefits to the masses and service citizens in a manner befitting the country that is today one of the world’s fastest growing economies – India.
About Medi Assist
Medi Assist manages corporate wellness programs for several of their 5000+ corporate customers. Rather than generic wellness activities, the company uses data analytics to develop wellness programs that meaningfully address the personalized requirements of each employee. The focus is both on preventive care and fitness as well as management of chronic conditions such as diabetes and hypertension. The company aims to create a virtual private ecosystem for corporates to promote healthy living and lifestyle among their member employees.