Secured Health Insurance Management

Summary

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 insurance's 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 India's 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 people's 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.