The Indian Health Insurance Revolution

Vivek Srivastava, CEO, HealthCare at HOME, IndiaAn alumnus of Indian School of Business, Vivek has operations and project experience in Fortune 500 companies like Indian Oil and Capital One. Prior to HCAH, he had worked with Berkley HealthEdu, Nova Surgery Centre & Nova IVI.

India is at the precipice of a global healthcare revolution with implementation of the Ayushman Bharat health insurance scheme which aims to provide a health insurance cover of Rs.5 lakhs to approximately 50 crore people for tertiary care. With implementation of the Ayushman Bharat Scheme, it is envisioned that the burden on hospitals will increase. Home healthcare presents itself as an immediate and effective solution to manage the expected rise in pressure on India’s medical infrastructure. Home healthcare is fast becoming an integral part of the Indian healthcare industry. The key driving factors are increase in geriatric population, rise in chronic lifestyle diseases, increasing trend of nuclear family system and most importantly, shortage of hospital beds and doctors.

But even with a CAGR of ~18 percent (as per Cyber Media Research’s report), home healthcare industry in India is yet to achieve its potential growth. This is largely because India’s home healthcare market is mostly unorganized and unregulated. The organized home healthcare sector, led by leaders like HealthCare at HOME, has grown leaps & bounds with advancement in technology with advance procedures like chemotherapy or setups like ICU now possible at patient homes. Quality players in home healthcare industry rely on latest technology to provide their services cost effectively and efficiently. Therefore, all services and activities related to patient’s care are duly documented digitally and can be audited at any time making them reliable. But needs ofregulation and standardization has still kept home healthcare solutions largely out of ambit of health insurance cover, and hence out of reach for many families.

Reimbursing home healthcare services or providing cashless facility for the same would ease many challenges faced by patients and their families. Current trend of nuclear families and multiple working professionals in a single household has made home healthcare facilities a highquality and cost-effective
solution for healthcare needs. It not just ensures mental peace and quick recovery for the patient by providing worldclass treatments at the comfort of patient’s home, but also reduces chances of hospital acquired infections significantly, which is among leading causes of prolonged hospital stays and readmissions. Furthermore, not only are home healthcare solutions more cost effective than hospitals, the patient also saves travel cost and other non medical expenditures involving hospital and health centre visits. For working professionals, loss in productivity is also prevented as they don’t end-up missing work to accompany ill family members to and at hospitals. With home healthcare set to be the next big thing in the Indian healthcare industry providing health insurance cover to home healthcare services could prove to be a differentiator for health insurers in a highly fragmented health insurance industry in India.

With benefits to hospitals, patients and insurance providers, home healthcare industry will lead a breakthrough in the Indian healthcare industry be reducing health-related economic burden on the patient and country at large

One such example is that of Magma HDI. Through its OneHealth insurance scheme, Magma HDI has taken a revolutionary step in the health insurance domain. Magma HDI has partnered with HealthCare atHOME (HCAH) to provide insurance cover for home healthcare services pro-vided by HCAH. A few insurance companies have started extending cover for certain day care treatments and OPD procedures like haemodialysis and chemotherapy. ICICI Lombard covers few home care treatments under OPD such as physiotherapy, consultation and diagnostics. Bajaj Allianz Health Insurance offers discounts to policy holders who avail services of some home care service providers with whom the company has tie-ups. SBI General Health Insurance covers home healthcare which includes parental care (attendant nursing charge to take care of your parents who are above 60 years of age); childcare (attendant escort charges to take care of your child below 10 years of age), and Convalescence benefit (which is available for insured above 10 years and below 60 years).

This indicates that there is indeed a big surge in interest of health insurance players in the home care sector. Standardization and regulation will ensure that many more insurance companies will hit the ground running to cover home healthcare in their health insurance cover.

Quality and Accreditation Institute of India (QAI) has already introduced standardization for the home healthcare industry in India, which will allow patients looking for home healthcare options to choose from credible player accredited by a body of renown and respect. HealthCare at HOME was the chair of the technical committee of QAI for drafting home healthcare accreditation standards. The standards rely on measurable criteria to ensure proper governance, competent human resources, adequate facility, appropriate information management, quality improvement opportunities, and safe practices. With standardization, health insurance agencies are bound to revise their policies to include home healthcare in a bigger way in health insurance cover, thus making home healthcare solutions more affordable for patients and their families.

With benefits to hospitals, patients and insurance providers, home healthcare industry will lead a breakthrough in the Indian healthcare industry by reducing health related economic burden on the patient and country at large.