Tieto presentation at ICMIF 5-5-5 Mutual Microinsurance Strategy country intervention launch event in India on 11 August 2016

1. SCALING UP HEALTH MUTUAL AID FOR LOW INCOME FAMILIES
Dr. Nandini KS
Uplift 2.0

2. 70% of the health
expenses in India
are incurred by
people from their
pocket
MACRO CONTEXT of HEALTH FINANCINGBACKGROUND
SCALINGUPHEALTHMUTUALAIDFORLOWINCOMEFAMILIES

3. 63 million people face
poverty every year due
to health care costs
alone
MACRO CONTEXT of HEALTH FINANCING…….continued
Photographer: Sumit Dayal /Bloomberg Markets

4. 80% of Rural and 82% of
Urban population not covered
by any Publicly financed
Health insurance scheme
MACRO CONTEXT of HEALTH FINANCING…….continued

5. THE MODEL OF MUTUAL
Risk Pooling by
Members

6. Solidarity and
Self Responsibility
THE MODEL OF MUTUAL

7. Decision makers and
Beneficiaries are the
same
THE MODEL OF MUTUAL

8. LOSS & SURPLUS
Sharing
THE MODEL OF MUTUAL

9. 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 1.0
SCALINGUPHEALTHMUTUALAIDFORLOWINCOMEFAMILIES

10. INCLUSIVE RISK POOLING
2004-2014 the four pronged approach
UPLIFT 1.0
RISK SHARING & PEOPLE OWNED TECHNICALLY ROBUST
HEALTH ECOSYSTEM BASED
SCALINGUPHEALTHMUTUALAIDFORLOWINCOMEFAMILIES

11. 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
SCALINGUPHEALTHMUTUALAIDFORLOWINCOMEFAMILIES

12. 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
SCALINGUPHEALTHMUTUALAIDFORLOWINCOMEFAMILIES

13. 2016 AUG ONWARDSUPLIFT 2.0
From BOT to B2C model
SCALINGUPHEALTHMUTUALAIDFORLOWINCOMEFAMILIES
2,50,000 in ten years
5,00,000 half a million
in 5 years now

14. 2016 AUG ONWARDSUPLIFT 2.0
Reach out to communities,
groups, families other than
microfinance
SCALINGUPHEALTHMUTUALAIDFORLOWINCOMEFAMILIES
2,50,000 in ten years
5,00,000 half a million
in 5 years now

15. 2016 AUG ONWARDSUPLIFT 2.0
Strengthen the health
services offering by
focusing on primary
health care
SCALINGUPHEALTHMUTUALAIDFORLOWINCOMEFAMILIES
2,50,000 in ten years
5,00,000 half a million
in 5 years now

16. 2016 AUG ONWARDSUPLIFT 2.0
Use technology for last mile
delivery of services and mutual
governance
SCALINGUPHEALTHMUTUALAIDFORLOWINCOMEFAMILIES
2,50,000 in ten years
5,00,000 half a million
in 5 years now

17. 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
SCALINGUPHEALTHMUTUALAIDFORLOWINCOMEFAMILIES
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

18. 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
SCALINGUPHEALTHMUTUALAIDFORLOWINCOMEFAMILIES
What do we need ?