Posted on Jul 29, 2010 by Sergio Ulloa
The Federation of Indian Chambers of Commerce and Industry (FICCI) has released the results of the developmental framework to provide high quality healthcare through insurance in a document titled "Health Insurance Report, 2010". Among the recommendations to give a boost to the health insurance sector, the report highlights the need for creating consumer awareness and satisfaction, quality healthcare delivery, improved insurance services, and an increased level of trust between insurers and healthcare providers.
FICCI includes in the report the results of deliberations from three working groups identified as follows;
(1.) 'Promoting Quality in Health care through Health Insurance',
(2.) 'Standardisation of Billing Procedures in Hospitals and Contents of Discharge Summary Format,' and
(3.) 'Standardisation of Third Party Administrator (TPA) and Insurer' and 'TPA and Hospital Contracts'.
The working group on topic (1.) proposes to develop a framework leading to 'Pay for Quality' by achieving a common approach to promote and measure the quality of the healthcare services delivered in the country, through the development of an incentive and disincentive mechanism applied by the insurance industry, using a uniform approach with standard parameters for Quality across the healthcare industry. Implemented over a number of years, the Group recommends a staged and transparent process, whereby providers are informed upfront on the quality expectations. Another objective is to bring small-, medium-, and large-sized healthcare providers into a uniform quality control process covering and leading towards accreditation and beyond, allowing them sufficient time to implement the essential criteria in a gradual manner, and develop their Quality systems and processes, having disclosed to them upfront the expectations and stages.
The part of the report by the working group on topic (2.) suggests standardising the billing formats and enabling the mapping of the hospital information systems in accordance with the specific data requirements of the insurance companies, in order to achieve a faster claims processing time and an enhanced analysis of information handled by all the healthcare providers in the country.
On topic (3.) the working group proposes the development of a basic template for TPA and insurer contract in order to achieve uniformity across the industry and avoid multiple versions in the clauses of the agreement.
With the goal of customer satisfaction at its core, the FICCI Report envisions an ideal universe of health insurance business, greater penetration of health insurance products and affordable quality healthcare for everybody.
Established in 1927, FICCI is the largest and oldest apex business organisation in India. Its history is closely interwoven with India's struggle for independence and its subsequent emergence as one of the most rapidly growing economies globally. FICCI plays a leading role in policy debates that are at the forefront of social, economic and political change. Through its 400 professionals, FICCI is active in 39 sectors of the economy. FICCI has joint business councils with 79 countries around the world.