Health-care costs can break your back, especially if you are diagnosed with a critical illness such as cancer. Insurance can cover a part of the cost. But associated expenses on consultation, diagnostic tests and medicine can leave your finances in a shambles.
Clearly, health insurance alone cannot help you. Fortunately, there's help from some start-ups, which are using technology and 'out-of-the-box' thinking to lower health-care costs.
Whether it is bringing together different health-care providers such as doctors, hospitals, clinics, diagnostic centres and pharmacists on one platform, providing home and preventive care services or integrating health records with electronic discount cards, these start-ups are doing it all.
The result is easier access to health care at lower prices. For example, cancer patients can now get chemotherapy at home, and that too at 30-40% lower prices.
Till a few years ago, it was impossible to think of such advanced medical treatments at home. But technology is helping start-ups offer advanced treatments at home at prices that are much less than what private hospitals charge.
We discuss some start-ups/companies in this space and how they are revolutionising the delivery of health care.
What it does: Started by serial entrepreneur K Ganesh, who launched ventures such as TutorVista, IT&T and Marketics, Portea Medical provides medical care at the doorstep. The offerings include services of nurses, doctors, physiotherapists and attendants. It also supplies medicines and equipment and conducts diagnostic tests at home.
"Though India has world-class tertiary (private) medical services, it does not have much in terms of homecare services. We have noticed that a patient needs to go to a hospital for just 30% problems. For the rest, home care can work. We are targeting that 70%," says Ganesh. Unlike most start-ups, which simply aggregate service providers, Portea has hired doctors, nurses and physiotherapists. It has a total of 1,000 employees. Ganesh says it requires a lot of training to deliver these services, which is not possible through part-timers Portea provides services in 18 cities and handles 20,000 home visits every month.
How cost effective it is: While home visits by doctors and nurses are not cheaper, those opting for home care after discharge from hospital can save up to 50%, says Ganesh.
"Typically, when a person stays in a hospital, there are a lot of attendant costs for things such as stay and food. The cost of treatment and travelling to the hospital for check-ups after discharge is additional," he adds. Ganesh says the biggest benefit of home care after discharge is not monetary saving but reduction in the risk of secondary infections (which patients are exposed to in a hospital.) "With secondary infections picked up in hospitals, patients have to be readmitted in up to 10% cases. In many cases, the complications can be serious," he says.
Portea also provides chemotherapy for 30-40% less than what hospitals charge. Take routine chemotherapy that needs to be given every month and takes about one hour to administer. The cost of drugs as well as admission, doctor, nursing and ancillary charges works out to be nearly Rs 25,000 (on the lower side) in an average private hospital compared to Rs 16,000 if the treatment is given at home.
Case Study / 65yrs (Requested Anonymity)
Background: The patient is suffering from cancer, which has spread to bones, lung and liver. It is at an advanced stage. Treatment includes an injection every month and anti-cancer, bonedirected therapy that reduces the spread of the cancer and adds calcium to bones. In case of treatment at a hospital, the patient needs to be admitted in the morning, with discharge after injection taking at least five hours, including admission and discharge procedure. In addition, the patient stays at a considerable distance from a multicare hospital and so has to travel 45 minutes to one hour one-way. Over the past few months, the patient has undergone treatment from the hospital twice. However, the patient found this challenging. The last four doses have been delivered at home through Portea.
ADVANTAGES OF PORTEA'S SERVICES
< Patient doesn't have to travel
< The care givers' (in this case, brother and sister-inlaw) routine is not disturbed
< Treatment can be given on holidays and at a time that's convenient to the patient, unlike in a hospital where treatment over the weekend is not ordinarily possible
< Receiving treatment at home is comfortable for the patient; lab samples prior to the injection can be provided at home and reports delivered over the email.
< Costs are significantly reduced (Rs 10,000 less) depending upon the cost of the drug
What it does: It is an online aggregator of healthcare service providers in 17 cities. It helps patients find doctors, hospitals, clinics and diagnostic centres and connect with them through telephone, online chat or e-mail. The service providers are listed based on speciality, location, qualification and experience. Medecure was started by Ketan Raiyani, a chartered accountant and a technology enthusiast, in 2011. Raiyani had earlier launched the tax management portal taxsmile.com.
"We provide an easy way for taking appointment with doctors, getting queries answered by experts and availing of services offered on the platform like diagnostic, treatment and home care. Essentially, MedeCure provides choice, convenience, savings and community support to users," says Raiyani. It also provides home care and health check-up packages.
MedeCure charges a subscription fee from doctors and health-care facilities. It does not charge anything from customers who use only its aggregation services. However, it charges for health check-up and home-care services.
How cost-effective it is: MedeCure, being a facilitator and aggregator, has a lot of negotiating power. It, therefore, provides services such as consultation, investigation and treatment at reasonable prices. Since this is an alternative channel for acquiring customers, health-care providers agree to offer their services to MedeCure users at reduced charges.
"The referral practice is rampant among health-care providers. Referral charges account for 35-40% fee. The fee that we charge from service providers is much less than that. This helps us offer services at lower prices," says Raiyani.
Naznin Sayed / 29 yrs
Background: Naznin Sayed approached MedeCure via phone to enquire about facilities in the Camp area of Pune city for getting a GI endoscopy done. MedeCure gave Naznin details of Dr Kayamkhani, an expert gastroenterologist. An appointment was booked for getting the endoscopy done.
Naznin, being a student was concerned about the cost of the procedure. MedeCure was able to speak to the doctor and get her a 25% discount on the basic cost.
ADVANTAGE OF USING MEDECURE
CHOICE - Verified expert/facility with credible experience and infrastructure
CONVENIENCE - Easy appointment booking and coordination for smooth delivery of services.
COST - Discount on diagnostic tests
MEDICAL SECOND OPINION
What it does: It offers second opinion through a panel of acclaimed Indian and international doctors either through teleconferencing or OPD centres in Tier-II cities. It has opened OPD centres in Jaipur, Patna, Indore and Jammu where doctors from big cities fly down to see patients.
Founded by Sachin Choudhury, Medical Second Opinion has renowned doctors such as Naresh Trehan, Devi Shetty and Sajan Hegde on its panel. It has 200 Indian and five international doctors across 11 specialties. The consultation charge for each doctor is the same as his/her OPD fee.
Among the other offerings are health cards and electronic health records. Health cards get you discounts on consultation, diagnostic tests and medicines, while the electronic health record facility enables a customer to save his health reports on a cloud-based platform so that he can keep track of his health. The health record service is offered free to anyone who has a health account.
How cost-effective it is: For a person living in nonmetros, where good doctors are in short supply, going to Delhi or Mumbai for consultation can mean a big expense on travel, food and lodging. Medical Second Opinion has sought to address this problem by opening OPD centres in Tier-II cities and flying down doctors there. The patient can consult a metro-based doctor by paying just the consultation fee.
Sachin Chaudhary, founder and CEO, Medical Second Opinion, says they have brought down the treatment cost to one-tenth in many cases.
What it does: The company calls itself a one-stop solution for all medical needs. Like Medecure, it is also an aggregator of hospitals, doctors, laboratories and clinics. It has 5,000 doctors and 80 affiliates (hospitals, diagnostic clinics and pharmacists) on its panel across the Delhi-NCR region.
"Based on users' need, we prescribe the best doctors, hospitals and diagnostic centres in and around their locality. We have empanelled doctors and hospitals based on our own ratings and user reviews," says Sandeep Gudapati, the head of India operations and an IIT-Roorkee alumnus. HealthIndya was founded by US-based Ashish Dhar.
Dhar also heads another start-up called Grand Opinion, which provides second opinion services. The start-up has big plans for electronic personal health records. It is looking to integrate the records with health discount cards. Gudapati says health records will be stored in chip-based cards.
HealthIndya is also planning to launch health cards which will double up as cashless health insurance cards. At present, its services are free for users. It charges service providers for using its platform. cost saving: Users get 20% discount on choosing service providers from the panel.
Though the health-care industry in India is growing at 15% a year, affordable health care remains a distant dream for millions.
Technological advancements have made it possible to treat many incurable diseases of the past. However, as equipment has become more sophisticated, costs have also shot up. Quality doctors remain scarce and, hence, are accessible only to those who can pay them well.
In the absence of a concrete health policy, private players have chipped in and improved the infrastructure. But they are driven more by profit than social motives.
How can we get out of this situation? Probably we need to change the traditional approach and think smart. These start-ups/entrepreneurs are showing us the way.
"The traditional approach has not worked so far. In such a situation, these non-traditional methods are welcome," says Charu Sehgal, senior director, consulting, strategy and operations, Deloitte Touche Tohmatsu.
She feels that the government has to change the role it is has played traditionally (provider of health care) and instead become a financier of health care by providing people health insurance so that they can pay for the services themselves.
A lot of effort has been made towards shifting the focus from tertiary care to preventive and primary care. Some start-ups and entrepreneurs are working towards making preventive health care more accessible.
"Preventive health check-ups help in early detection of a disease which otherwise can become life-threatening and cost a lot," says Amol Naikawadi, joint managing director, Indus Health Plus, a preventive health check-up company.