Secured Health Insurance Management

Title

Secured Health Insurance Management

Creator

Ravisankar A.; Manikandan P.; Muda I.; Kulkarni S.V.; Castillo R.M.T.; Jose Anand A.

Description

Many Low- and Middle-Income Countries (LMICs) have expanded their healthcare coverage over the past decade thanks to reforms and investments motivated by Universal Health Coverage (UHC). UHC strives to guarantee that all individuals have access to high-quality healthcare, protecting them from public health hazards and financial hardship caused by the need to treat sick family members. With UHC as its end objective, this study examines health insurances function as a policy instrument to address health funding. Here, researchers study the laws to ensure that all Indians have access to health care and how technology facilitates quicker participation in health insurance programs. The data was collected between August and October of 2022. The study was designed as a cross-sectional case study: (i) the research on the effects of UHC, (ii) documents about Indias health insurance systems (HIS), and (iii) a discussion of the benefits and challenges of using MedStrat, a homegrown digital Health Insurance Management System (HIMS), to run health insurance programs across different states in India. Data from research and document evaluations, as well as health insurance statistics, were triangulated with modern technology adoption models to determine (i) factors that influence the rate at which digital insurance plans are adopted, (ii) the effect of technology on increasing peoples access to health insurance; and (iii) the potential for the digital insurance intervention to be scaled further. Digital insurance administration systems can increase insurance enrolment, especially among low-income households. There are three enabling contexts for digital insurance plan adoption: supportive regulation, public-private partnerships, and ongoing stakeholder contact and education. There are three essential requirements for digital health insurance programs to be widely adopted in India and other similar situations. (i) user-friendliness; (ii) an established network for digital insurance policies; and (iii) confidence, which may be shown through measures like encrypted data storage, complete audit trails, and built-in fraud protection. Our results prove that digital health technologies hold great promise for achieving UHC in LMICs. 2024 Scrivener Publishing LLC.

Source

Artificial Intelligence-Based System Models in Healthcare, pp. 425-448.

Date

2024-01-01

Publisher

wiley

Subject

Digital technologies; health insurance; national health insurance scheme (NHIS); scale-up; UHC

Coverage

Ravisankar A., Department of Management Studies, Erode Sengunthar Engineering College (Autonomous), Tamil Nadu, Thudupathi, Perundurai, Erode, India; Manikandan P., Department of Electrical and Electronics Engineering, K.S.R. College of Engineering, Tamil Nadu, Tiruchengode, Namakkal, India; Muda I., Public Sector Accounting, Universitas Sumatera Utara, Jl. Dr. Mansyur Padang Bulan, Medan, Indonesia; Kulkarni S.V., School of Business and Management, CHRIST (Deemed to be University), Bangalore, India; Castillo R.M.T., Department of Information Technology, Escuela Superior Politnica de Chimborazo (ESPOCH), Sede Orellana, El Coca, Ecuador; Jose Anand A., Department of ECE, KCG College of Technology, Tamil Nadu, Karapakkam, Chennai, India

Rights

Restricted Access

Relation

ISBN: 978-139000000-0; 978-139424249-8

Format

Online

Language

English

Type

Book chapter

Identifier

https://doi.org/10.1002/9781394242528.ch17

https://www.scopus.com/inward/record.uri?eid=2-s2.0-85214608156&doi=10.1002%2f9781394242528.ch17&partnerID=40&md5=13e0d9c1bcd3e6b1e2af03a8d5571b0b