Developing new products for outpatient healthcare

Over the past decade, the Government of India has made significant investments in the public health system to bring healthcare closer to households even in rural and remote areas. However, factors such as shortages of medical personnel and quality drugs in rural areas continue to limit use of the public health system. This has forced a significant portion of the population to seek healthcare from the private sector, a costly endeavour for most Indians. As part of its efforts to reduce the burden of healthcare costs, ICICI Foundation has partnered with ICICI Lombard General Insurance Company to design and support the delivery of the first outpatient insurance product for India’s poor.

The project aims to lower the out-of-pocket healthcare expenses for India’s rural poor by creating affordable and reliable options for outpatient healthcare. The project will offer outpatient insurance in conjunction with the Government of India’s national health insurance scheme for inpatient care, the RashtriyaSwasthyaBimaYojana (R S B Y). This outpatient insurance will be piloted first in Puri district in Odisha and subsequently in Mehsana district in Gujarat, providing recipients with reliable and affordable outpatient healthcare 24x7 at empanelled government and private outpatient clinics and hospitals.

Supporting government initiatives in this way allows ICICI Foundation to drive widespread change in the way the poor receive healthcare. This product is expected to transform the health and financial security of low-income households in the pilot districts by improving access to timely and quality healthcare, strengthening the delivery of essential health services in rural and remote regions of the country and building critical health capabilities among low-income households to support their participation in the economy.

The project will also have a positive impact on the supply side of outpatient healthcare. It is expected that there will be an increase in the network of hospitals, clinics and pharmacies in both locations to meet the increased demand for outpatient care.

The two-year pilot project will impact more than one million lives, and the lessons that emerge from this project will inform and shape future delivery and financing of healthcare in India.

In addition to funding the project, ICICI Foundation is serving as the chief learning partner for the project. Since this is India’s first outpatient healthcare-based insurance project, ICICI Foundation will be closely examining the outcome. ICICI Foundation will evaluate the impact of the project on overall health indicators in both districts and assess how the inpatient and outpatient products work together and what impact they have on drug prescription patterns, out-of-pocket expenses and access to healthcare.