H.E.A.T 2016: Day 2: Cognito: “Health Insurance in India: Journey so Far and the Road Ahead for Indian Hospitals”,Mr. Gaurav Tripathi, Associate VP, Aditya Birla Financial Shared Services Limited

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Mr. Gaurav Tripathi, AVP at Aditya Birla Financial Shared Services Limited began the session by interacting with students on basic healthcare concepts. He stated the difference between health insurance and wellness insurance. While a health insurance takes care only of a serious dip in the insuree’s health, a wellness insurance ensures that you enjoy a minimum level of wellness too. He also said that insurance companies are trying to move away from health insurance to wellness insurance in terms of service offerings.

He explained the evolution of health insurance in India since 1986. The Introduction of IRDA bill and the growth of cashless-admission schemes are few of the major developments the healthcare sector has seen. Indian healthcare sector adopted western policies of asking hospitals to adhere to qualities and standards. Hospitals were forced to maintain proper reports and computerize important activities.

Mr. Tripathy also spoke about various healthcare financing options such as Savings (fee for service), User fees (capitation), Demand Side Financing, Private Health Insurance, Community Health Insurance, Social Health Insurance and General Taxation Funding. He then explained the difference between less equitable financing options and more equitable financing options.

Moving on, Mr. Tripath spoke about de-tariffication policy (2007) and medical inflation. He also focused on various challenges in the healthcare industry such as increasing claim costs, forgeries, lack of standard treatment protocol, imperfect information, non-comprehensive coverage and government interventions.

He concluded by asking the students not to look only into sales but also into approvals, differentiators, market research and product development when developing a health insurance model.

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