For a Model of Accountable Care

Context: There is a need to adopt a system of accountable healthcare rather than depending only on the insurance mechanisms to fight the pandemic.

Insurance Measures Taken:

• Standard Covid-19 insurance cover: will be offered by insurers as directed by the Insurance Regulatory and Development Authority (IRDAI) 

• This will help lower the tariff and provide choices to the consumer.

Insufficiency of Traditional Insurance:

• Neglecting Long term effects: The virus can cause long term damage to the internal organs. 

• Suboptimal Solution: only tweaking the traditional insurance covers.

• Failure in harmonising incentives: between hospitals (want to inflate costs) and insurers (want to minimise the payout).

Accountable Healthcare:

• Focus on quality healthcare: reduce per-capita cost of healthcare rather depending only on insurance.

• Aligns incentives: Healthcare providers undertake to keep a defined population in good health for a fee per capita worked out deploying actuarial expertise used by insurers.

• Robust Regulation: and danger of reputational damage lessen the risk of short-changing on care to shore up margins.

• Removes incentive to inflate costs: though needless procedures or treatments.

• Payment by State: in case of poor, joint payment in case of better-off and individual payment in case of well off.