- Adequate hospital capacity: Hospitals are keen to get empanelled and offering discounts and procedure wise fixed prices to increase patient flow. We operate a complex 'cashless hospitalisation scheme' for the poor; inclusive of – preauthorisation, 1month credit, 20-30% discount on the rates, etc
- Willingness of doctors to partner: Doctors are keen to partner to increase patient flow and reputation in the area. With minimal capitation fees, they offer discounts of upto 50% on their consultation fees
- Consumer's willingness to pay: There is significant demand for a health scheme providing easy utilisation and effective servicing, at the price point of Rs 800-1000 per family. Some of the villages with high utilisation have seen a penetration of ~40%
- Insurance insulates from "poverty trap": Market research indicates that ~60% of all inpatient events lead to lowincome families sellingoff assets or taking loans at very high interest rates (35% per month) and hence, being caught in a 'poverty trap'
- Primary/preventive care reduces cost: Intervention through primarycare and preventivepromotive services is essential to reduce the cost of the entire ecosystem; and make the scheme affordable and sustainable. Example: 41% of our inpatient cases are waterborne which are preventable. Also, the outpatient network reduced the inpatient claims by ~3 times compared to areas where there was none
- Outpatient benefits increase "willingness to pay": Our experience has shown that outpatient benefits also increase the possibility of a renewal by 3 times. The perceived benefit is that savings from drugs and consultation would 'pay back' the onetime investment towards annual premiums
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