by Suman Gupta
Announced at the Raksha Summit 2024, the framework envisions a “Health JAM Trinity” – A Unified Approach of Health Data, Automation, and Mobile-Enabled Healthcare to Realise the Viksit Bharat Vision
November 22, 2024, Mumbai: Aligning with India’s “Viksit Bharat by 2047” mission, Medi Assist Healthcare Services Ltd. (“Medi Assist” / “Company”), India’s leading Health Benefits Administrator, and Boston Consulting Group (BCG) unveiled a transformative framework for Borderless Health at the Raksha Summit 2024 held in Mumbai today. A Medi Assist vision, the framework seeks to address healthcare disparities and ensure universal, high-quality, and accessible health coverage for all Indians.
The report highlights key structural, social, and economic barriers, proposing a data-driven, technology-enabled model to revolutionise access and efficiency. Borderless Health aims to tackle pressing challenges such as gaps in investments, insurance coverage, and the imbalance between curative and preventive care spending.
At the heart of Borderless Health is the Health JAM framework, a trio of technological enablers: Joined Health Data – 100% digital health data; Automation – leveraging AI for automated claims, personalised packages and fraud detection,; and Mobile-Enabled – on demand provision of available capacity and carer across locations. Together, these pillars will revolutionise how healthcare is delivered across India.
To achieve universal, cashless healthcare by 2047, the report underscores the critical role of collaboration & coordinated efforts needed among the key stakeholders of the healthcare ecosystem. Strategic milestones include achieving 90% universal health insurance by 2035 and deploying a fully interoperable health data system by 2040.
“We need to galvanise collective action across healthcare providers, insurers, employers, and policymakers to transform this vision into reality, ensuring equitable healthcare access and empowering every Indian with quality care” said Alpesh Shah, Lead – CEO Advisory APAC, Managing Director and Senior Partner at BCG
“Insurers & providers must solve for three unique India’s overcoming their unique needs & challenges. Flipping the paradigm towards at-home preventive care and expanding the reach of our SMEs as employers are two real opportunities. Players who attack some of these opportunities backed by AI & digital will steal a march” said Swayamjit Mishra, Managing Director and Partner, Core Member Financial Services and Technology Lead in Insurance, APAC, BCG
“In a world where health knows no borders, true progress lies not just in access to care but in the belief that every individual, no matter where they are, deserves on-demand access to health and wellness. This vision calls on all stakeholders to unite in building a resilient, equitable healthcare system for generations to come.“ said Satish Gidugu, CEO, Medi Assist
Key Insights From The Report :
● The Three Vectors of Health Benefits Delivery : To achieve Borderless Health, India needs to optimise health benefits delivery across three key vectors
● G2C (Government to Citizen): Focuses on expanding government-backed schemes like Ayushman Bharat to include preventive and chronic care.
● E2E (Employer to Employee): Encourages employers to offer comprehensive group health insurance plans.
● B2C (Business to Customer): Promotes customised retail health insurance plans for wider coverage.
● Key Features of Borderless Health : India’s National Health Stack is envisioned as a world class Digital Public Infrastructure.
● Policy framework: Establishes a foundation for “Insurance for All” and “Cashless for All” healthcare delivery.
● Borderless benefits: Enables citizens to access relevant healthcare packages across socio-economic and geographic segments.
● The Future of Healthcare, A Data-Driven Approach : By leveraging the power of Patient 360, a unified platform that captures and analyses patient data, India can revolutionise its healthcare system.
● Introducing the Health ‘JAM’ Trinity to create Patient360, Network360 and Provider360
○ Joined health data: 100% tokenized, digital health data; Universal, all hospitals, all treatments by default; Consent-based access to ecosystem.
○ Automation: Driving a step-change in efficiency & experience. Automated claims assessment and processing; Personalised packages creation at segment-of-one; Fraud detection; Sharper pricing.
○ Mobile enabled healthcare: Empower citizens on “choice”; On-demand provision of available capacity; carer and location; Self-serve, education & preventive.
About Medi Assist Healthcare Services : Medi Assist Healthcare Services provides third party administration services to insurance companies through its wholly owned subsidiaries, Medi Assist TPA and Raksha TPA (from 25th August 2023). As a third party administrator, the Company acts as a facilitator between (a) insurance companies and their policyholders, (b) insurance companies and healthcare providers (such as hospitals), and (c) the Government and beneficiaries of public health schemes. The Company, through Mayfair We Care provides benefits administration services to Indian corporates & insurers as well as global insurers and beneficiaries. The Company also facilitates other healthcare and ancillary services such as hospitalisation services, call centre services, customer relations and contract management services, billing services and claims processing services through our Company and our other Subsidiaries. Medi Assist is listed on both the National Stock Exchange (NSE) and the Bombay Stock Exchange (BSE). For more information, please visit: www.mediassist.in.
About Boston Consulting Group :Boston Consulting Group partners with leaders in business and society to tackle their most important challenges and capture their greatest opportunities. BCG was the pioneer in business strategy when it was founded in 1963. Today, we help clients with total transformation — inspiring complex change, enabling organisations to grow, building competitive advantage, and driving bottom-line impact. To succeed, organisations must blend digital and human capabilities. Our diverse, global teams bring deep industry and functional expertise and a range of perspectives to spark change. BCG delivers solutions through leading-edge management consulting along with technology and design, corporate and digital ventures — and business purpose. We work in a uniquely collaborative model across the firm and throughout all levels of the client organisation, generating results that allow our clients to thrive.
