icmif 5-5-5 launch: uplift mutuals presentation
TRANSCRIPT
SCALING UP HEALTH MUTUAL AID FOR LOW INCOME FAMILIESDr. Nandini KS
Uplift 2.0
70% of the health expenses in India are incurred by people from their pocket
MACRO CONTEXT of HEALTH FINANCINGBACKGROUNDSC
ALIN
G UP
HEA
LTH
MUT
UAL
AID
FOR
LOW
INCO
ME
FAM
ILIE
S
63 million people face poverty every year due to health care costs alone
MACRO CONTEXT of HEALTH FINANCING…….continued
Photographer: Sumit Dayal /Bloomberg Markets
80% of Rural and 82% of Urban population not covered by any Publicly financed Health insurance scheme
MACRO CONTEXT of HEALTH FINANCING…….continued
THE MODEL OF MUTUAL
Risk Pooling by Members
Solidarity andSelf Responsibility
THE MODEL OF MUTUAL
Decision makers and Beneficiaries are the same
THE MODEL OF MUTUAL
LOSS & SURPLUS Sharing
THE MODEL OF MUTUAL
Pioneered pure health mutual starting from Urban then rural and then tribal low income populations
Cover low income communities, people earning about 2-6 $ a day
Developed Mutuals with 9 low income communities that today cover over 250000 lives,
Developed the BOT model
2004-2014UPLIFT 1.0SC
ALIN
G UP
HEA
LTH
MUT
UAL
AID
FOR
LOW
INCO
ME
FAM
ILIE
S
INCLUSIVE RISK POOLING
2004-2014 the four pronged approachUPLIFT 1.0RISK SHARING & PEOPLE OWNED TECHNICALLY ROBUST
HEALTH ECOSYSTEM BASEDSCAL
ING
UP H
EALT
H M
UTUA
L AI
D FO
R LO
W IN
COM
E FA
MIL
IES
2004-2014 Model ImpactUPLIFT 1.0
One of the handful of entities with both urban and rural footprints
Only member contribution is used for benefit payments and is governed by members (Pure Mutual)
Focus on Risk Reduction and Client Engagement results in high satisfaction and consistently good renewal rates (avg 70%)
Focus on systems standardization and use of technology has made the model replicable (Pune, Mumbai, Tribal Rajasthan- benefits payment possible in 3 hrs)
Lakhs of rupees saved every year thanks to the bouquet of health services including 24X7 Helpline, Multi-layered Preferred Provider Network, Out Patient posts, Health Campaigns
SCAL
ING
UP H
EALT
H M
UTUA
L AI
D FO
R LO
W IN
COM
E FA
MIL
IES
2004-2014 Model LearningsUPLIFT 1.0
Takes about 5-8 years for a mutual in the micro space to be stable
Initial investment (3-5 yrs) in setting up health services, client governance and trainings and back
office systems is high, cannot be funded by premiums (affordability factor)
Every new mutual (setup) comes with its own learning curve and is time consuming
Mutuals require numbers and small pools are not viable in the long run (20-50 yrs)
Technology is the way forward if distribution and servicing costs have to be lowered and mutuality
has to be maintained
SCAL
ING
UP H
EALT
H M
UTUA
L AI
D FO
R LO
W IN
COM
E FA
MIL
IES
2016 AUG ONWARDSUPLIFT 2.0
From BOT to B2C model
SCAL
ING
UP H
EALT
H M
UTUA
L AI
D FO
R LO
W IN
COM
E FA
MIL
IES
2,50,000 in ten years 5,00,000 half a million in 5 years now
2016 AUG ONWARDSUPLIFT 2.0
Reach out to communities, groups, families other than microfinance
SCAL
ING
UP H
EALT
H M
UTUA
L AI
D FO
R LO
W IN
COM
E FA
MIL
IES
2,50,000 in ten years 5,00,000 half a million in 5 years now
2016 AUG ONWARDSUPLIFT 2.0
Strengthen the health services offering by focusing on primary health care
SCAL
ING
UP H
EALT
H M
UTUA
L AI
D FO
R LO
W IN
COM
E FA
MIL
IES
2,50,000 in ten years 5,00,000 half a million in 5 years now
2016 AUG ONWARDSUPLIFT 2.0
Use technology for last mile delivery of services and mutual governance
SCAL
ING
UP H
EALT
H M
UTUA
L AI
D FO
R LO
W IN
COM
E FA
MIL
IES
2,50,000 in ten years 5,00,000 half a million in 5 years now
2016 AUG ONWARDSUPLIFT 2.0
Support from the 5-5-5 Strategy of ICMIF that seeks to cover 5 million families in 5 countries in five years
Support from Mutual Insurance Company in Canada “the Cooperators” established member of ICMIF
SCAL
ING
UP H
EALT
H M
UTUA
L AI
D FO
R LO
W IN
COM
E FA
MIL
IES
How are we going to do it?
Support from TIETO on the technology front
Support from Aasra to reach out to newer communities
Decade of learning and a motivated team
2016 AUG ONWARDSUPLIFT 2.0
Need your BLESSINGS and
Support in reaching to new communities and groups that may be interested in joining the mutual model
SCAL
ING
UP H
EALT
H M
UTUA
L AI
D FO
R LO
W IN
COM
E FA
MIL
IES
What do we need ?