Medical inflation is a key driver of health insurance costs and premium increases. Health insurance companies are continuously looking for ways to better manage medical inflation to keep premiums competitive for customers and to mitigate lapses.
Despite adopting many initiatives on claims management, fraud management, provider networking and case management, most insurers are still struggling with medical inflation. With new players entering the market that have competitive pricing and product offerings, this becomes more important.
In this paper, Milliman’s Rachin Aggarwal and Joanne Buckle discuss common definitions of medical inflation, factors driving medical inflation in the short and long term and current medical inflation trends in India. They also cover the Insurance Regulatory and Development Authority of India (IRDAI) regulations on rate filing and restrictions on premium rate increases in the context of how companies are currently adjusting their premium rates for medical inflation. In addition, they provide insight into current practices and levels of premium increases in Indian and international health insurance markets and the way forward.
Innovations in healthcare technologies have been growing, which is evident by the increasing attention of the venture capital industry. Health insurers can harness these technologies directly or indirectly in many ways that may result in increasing efficiency in operations, decreasing healthcare costs and improving customer satisfaction.
Most innovative solutions use the existing power of internet, mobile phones, 3D printing, artificial intelligence, machine learning and traditional information technology to create answers to industry-wide challenges.
In this paper, Milliman professionals discuss innovative solutions that can be harnessed directly by health insurers in different parts of the world. They classify healthcare technologies into three categories.
Private health insurance
in India has seen continuous growth since private players entered the market in
2001 and standalone health insurance companies started entering the market in
2007. Even though several new products and services have been added by the
private players, such as top-ups, disease-specific programmes,
wellness-focused strategies, critical illness coverage and hospital cash among
others, the market is still
dominated by variants of Mediclaim, which public sector companies started to
offer before privatisation of the insurance sector.
While all Mediclaim
products have similar benefit designs, there are some differences, including
but not limited to:
- Waiting period for pre-existing diseases
- List of exclusions
- Sub-limits for services such as room rent or ICU
- Condition-specific sub-limits
- Inclusion of maternity benefit
- Member co-payments
- Size of hospital network
- Premiums charged for similar coverage
In this article, initially published in Asia Insurance Review, Milliman’s Rachin Aggarwal and Abhishek Agrawal examine how a standard health product would benefit various stakeholders, including consumers, insurers, providers and regulators and policy makers.
Mental health is a major concern worldwide with approximately 14% of the global burden of disease attributable to neuropsychiatric disorders. In India, mental healthcare faces challenges in terms of existing public health priorities and their influence on funding, shortage of mental health services facilities and resources, poor utilisation of available services by patients and caretakers and issues with the recovery and reintegration processes of those who are mentally ill.
The Mental Healthcare Act, 2017 (Act) was passed in India in April 2017 and put into effect in July 2018. It grants a legally binding right to mental healthcare to all citizens of India and is intended to set a foundation for delivering high-quality healthcare and protecting the rights of individuals receiving such care.
The Act aims to bring a number of changes in the healthcare sector through provisions that place greater emphasis on the type of care, treatment, and welfare of those suffering from mental illness. Additionally, the Act places an obligation on insurance companies to provide health insurance for mental illness on the same basis as other physical illness.
In this paper, Milliman’s Joanne Buckle, Neha Taneja, Rachin Aggarwal and Vidhi Gupta look at the key provisions of the Act, mental illness prevalence, supply-side indicators and the current treatment gap. They also discuss the results of an industry survey they carried out to understand the impact of the Act on the Indian health insurance market and the mental health landscape in select international markets to arrive at key learnings for the Indian market.