52 mins ago
Predictable Hospital Rates Could Improve Health Insurance Efficiency
Mayank Bathwal says hospitals and insurers should use clearer and more predictable prices.
He says hospitals could follow common treatment methods and rate categories.
The National Health Claims Exchange could help hospitals and insurers share information through one system.
This could make admissions, discharges and insurance claims faster.
Bima Sugam could help people buy insurance products without relying as much on intermediaries.
Bathwal also says outpatient care can help people notice health problems earlier.
Aditya Birla Health Insurance rewards some customers for healthy behaviour.
About 9,200 customers received all of their premium back, according to the company.
Mayank Bathwal said standardised hospital rates would make healthcare costs more predictable rather than simply lower them.
He said wider use of the National Health Claims Exchange could streamline hospital admission, discharge and claims settlement.
Bathwal described Bima Sugam as a common insurance platform that could reduce distribution costs and help prevent mis-selling.
He said preventive care and outpatient coverage can increase health awareness and enable earlier intervention for conditions such as diabetes and high blood pressure.
Aditya Birla Health Insurance said about 9,200 customers received 100% premium refunds for maintaining good health, while health-focused customers showed lower claims and higher persistency.
- Who
- Mayank Bathwal, chief executive officer of Aditya Birla Health Insurance Company, discussed the issues.
- What
- The interview examined standard hospital rates, the National Health Claims Exchange, Bima Sugam and preventive health insurance.
- Where
- The article does not specify a location for the interview.
- When
- The article does not specify when the interview took place.
- Why
- The proposed measures are intended to improve predictability, transparency and efficiency in healthcare costs, claims and insurance distribution.
Key facts
- Healthcare-cost share
- Bathwal said healthcare costs account for about 70% of insurers’ costs.
- Claims exchange
- The National Health Claims Exchange is described as an integration layer for data exchange between hospitals and insurers.
- Expected benefit
- The exchange could improve transparency in costs and timelines and reduce delays in admission, discharge and claims settlement.
- Bima Sugam
- Bathwal described Bima Sugam as a common layer owned by insurance companies that could reduce distribution costs and improve transparency.
- Premium refunds
- About 9,200 customers received 100% of their premium back for good health behaviour, according to Aditya Birla Health Insurance.
- Health rewards
- About 12% of the company’s consumers earned some benefit for good health behaviour, while 5–6% earned a sickness benefit.
- Reported customer outcomes
- The company said its health-benefit cohort had a 6–7% lower claim ratio and 12–13% higher persistency.
Sources
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