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Grantee
CARE Foundation is a non-profit organization with the mandate to make quality health care affordable and accessible to all through the appropriate use of technology. The Foundation implements its mission in three main ways: a) conducting research and providing specialized training, b) developing cost-effective medical products, and c) providing healthcare to low-income populations.
To increase access to health in rural areas, the Foundation relies on local capacity building and technology solutions, implements solutions to create a more efficient supply chain, and has launched a microinsurance program. The Foundation works with innovative health care approaches such as tele-medicine, digital catheterization laboratory, and robotic surgery.
Consortium member:
The Centre for Insurance and Risk Management (CIRM) is a non-profit organization engaged in a variety of action research initiatives with insurers, NGOs and regulators to design and promote innovative insurance products and to improve knowledge on risk-mitigating mechanisms. CIRM is one of 6 specialized centres associated with the Institute of Financial Management and Research (IFMR).
Project Summary
- Project name: Insuring primary care - A sustainable financing solution for rural primary health
- Project start date: June 2009
- Duration: 3 years
- Country: India
Beneficiaries
The project targets agricultural workers whose average household income is below INR 2500 per month (US$ 55). It will also benefit low-income communities in rural areas such as nomadic tribes that have scarce access to healthcare facilities. The Foundation plans to provide health microinsurance in 50 villages that have approximately 100,000 residents.
Project Description
The project aims to study the impact of microinsurance coupled with healthcare services delivered through handheld devices. In rural areas, the population generally can only access poorly qualified medical professionals for primary care. Additionally, high illiteracy, and a general lack of awareness about good health practices and the importance of managing risks makes microinsurance very difficult to implement in rural India.
To address these challenges, CARE Foundation plans to educate and train Village Health Champions (VHCs) to maintain a health database for their village and to facilitate access to medical advice from specialists through mobile communications. The role of the VHC includes health education, illness prevention, promotion of hygiene, assistance with referrals and transportation to medical facilities. The VHC network is supported by a primary health centre staffed by a medical officer, remote doctors consulting team, Nurse, Pharmacist and laboratory technician, and which can provide minor procedures, drugs and, diagnostic services.
CARE Foundation is partnering with CIRM to create a microinsurance product sold by VHCs through pre-paid cards. Members will receive free services from the VHC network plus assistance to obtain hospitalization wherever required. The enrolment campaign will be supported by an insurance literacy program and (free distribution of preventive products or services to provide clients with some immediate value for their money). Renewals will be encouraged by discounted premiums, and/or increased benefits.
Through voluntary health insurance, the project will enable consumers to make informed choices. It is expected that the overall treatment cost will be reduced through prevention, early diagnosis and timely care emphasizing best practices at the hospital. Tele-monitoring will be used for after-care service to prevent re-hospitalization and conduct quality control.
Key Challenges
- The possibility of a systemic risk, like epidemics or natural disasters affecting the
entire covered population could have adverse consequences for the scheme.
- The acceptability of tele-medicine and the success of the newly launched government
sponsored health insurance scheme shall directly affect the success of the project.
- Covering costs of the benefits for outpatient care through relatively small premiums might
challenge the sustainability of the project.
Learning Agenda
The overall goal is to ascertain the efficacy and viability of outpatient financing and health care delivery in four key aspects:
- To what extent does technology enhance access and utilization of health care, facilitate
claim processes, reduce costs and increase savings?
- How does the model support the efficiency of the scheme in terms of claims management,
cost reductions, healthcare expenditures, operating costs and renewal rates?
- To what extent are VHCs effective in the prevention of diseases and promotion of healthy behaviour?
- To what extent does the model contribute to health care delivery, and patient and provider satisfaction?
More information on the project
Website of the grantee:
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