"India Needs Standard Protocols in Healthcare"
Out-of-pocket expenditure accounts for 62 per cent of the total healthcare spending against a global average of 18 per cent, underlining a significant gap between requirement and pre-financed health coverage
Health insurance is one of the fastest growing segments in the insurance industry. However, only 27 per cent of Indians have opted for health coverage, according to a recent report jointly published by FICCI and KPMG. The study also reveals that out-of-pocket expenditure accounts for 62 per cent of the total healthcare spending against a global average of 18 per cent, underlining a significant gap between requirement and pre-financed health coverage. In a conversation with Teena Jain Kaushal, Antony Jacob, CEO of Apollo Munich Health Insurance, discusses the challenges faced by the health insurance sector in India and what will drive growth in 2018. Edited excerpts:
Q: What are your views on IRDAI's recent move to link Aadhaar with insurance policies?
A: Making Aadhaar-insurance linking mandatory is a good initiative, in sync with the government's digitisation mission. The new mandate will help streamline the KYC (know your customer) process and prevent fraudulent claims. It strengthens our capabilities to know our customers better and service their needs. Such an initiative will also make the claim process faster. Initially, there could be short-term challenges, but in the long term, it will help minimise inconveniences and improve overall customer experience.
Q: What is your take on the use of wearables in healthcare and health insurance space?
A: Wearables in healthcare and health insurance are an enduring trend. A future with integrated wearable devices looks promising, but our company has a different approach. We think the use of mobile technology may equally serve the purpose. Smartphone apps provide the same cutting-edge user experience that the trending wearable devices claim to deliver. Moreover, people tend to discard wearable devices after some time, but they will never stop using their smartphones. So, it is wiser to use handheld devices.
Apollo Munich has launched Stay Active to help people to lead a healthy and avoid the hassles of buying wearable devices. The programme enables policyholders to earn up to 8 per cent renewal discount depending on the distance they walk during a year. Customers just need to download our Health Jinn app on their Apple or Android phones to avail the benefit. We are trying to ensure better engagement with the help of this app, and a renewal discount encourages people to take more steps towards a fitter future.
Q: How affordable is Indian healthcare compared to the West?
A: Affordability and quality of healthcare are corroborated by the growing number of medical visas issued by India, which increased 45 per cent in 2016 compared to the year before. India is rapidly growing as a medical hub, and it is strengthening the country's position as a preferred destination for medical tourism. Medical treatments available here are cost-effective - around one-tenth of what they cost in the US and Europe. So, India is taking a lead in this space.
Q: What are the global practices India should adopt?
A: In India, low adoption of standard protocols for various treatments leads to a difference in healthcare cost. Hence, a standardised system should be established, which could help develop appropriate insurance products. Data standardisation also plays a significant role in creating a common format that allows all stakeholders to collaborate in an efficient manner while using various information-processing tools. Also, in developed nations, more importance is given to safeguarding the health of an individual rather than just supporting healthcare cost. In the developed countries, wellness programmes by insurers have proved to be instrumental in this regard, and Indian insurers have started following suit.
Q: Why don't insurance companies negotiate with hospitals to ensure standard procedures?
A: Unlike health insurance, healthcare is a state and central subject. Hence, standard protocols are difficult to implement. As a result, tools to regulate healthcare charges are currently limited. From procedures to diagnostics to treatment - the cost of each component depends on the cost incurred by individual providers. We are now negotiating certain packages with our network providers to ensure better utilisation of our customers' health insurance.
Q: Medical conditions such as depression are not yet covered in India. What should be done to expand the coverage?
A: In India, there are still taboos and stigmas around mental health problems due to which people don't seek proper treatment. Also, mental health professionals, especially those who are well trained and certified, are too few in our country - 0.3 psychiatrists per 1,00,000 people. Nevertheless, health insurers are taking necessary steps in line with he Mental Healthcare Bill 2016 to bring mental illnesses under insurance cover. Apollo Munich's customised group health insurance plans already cover this segment. But we are still working to include mental health under our existing products.
Q: How can we integrate technology for hassle-free, faster claim settlement?
A: Multiple stakeholders are involved here - providers, customers, insurers and so on. So, a lack of consolidated data and manual interventions sometimes slow down the processes. Automating the entire claims process will reduce turnaround time and provide a seamless experience to customers. The use of technology further ensures better loss control, ease of application and reduced processing cost. Currently, we are working on data analytics that will help determine the right package cost for our network of hospitals. Also, cashless reimbursement and claims processing will be much faster.