Quality Wave in Healthcare – is it real or is it a mirage

July 3, 2017 by · Leave a Comment
Filed under: Healthcare, Healthcare Quality, Hospital, NABH 


Author: D.Satishkumar, Principal Consultant Value Added Corporate Services P Ltd

The healthcare sector in the country has witnessed a lot of changes over the past few years. One of the changes to have happened is in the area of quality of healthcare delivery and the necessity to introduce accreditation / certification systems to evaluate and monitor the same.

NABH Accreditation assumes larger significance in this context. Accreditation relies in establishing the technical competence of an organisation to deliver services adhering to specific standards.

The hospital accreditation program (NABH) was launched in the year 2006 in the country. Initially NABH came up with 2 set of standards, one for hospitals with more than 50 beds which was called as NABH Accreditation and another standard for hospitals between 20 & 50 beds called NABH SHCO (Small Healthcare Organistions)

Initially there were a very few takers as Quality and Accreditation were something which were alien to the healthcare sector. The first wave to go for accreditation started gaining momentum when in the year 2008 / 2009 CGHS made accreditation standards mandatory for hospitals which needed empanelment with them. Hospitals which had empanelment with CGHS and which wanted to empanel with CGHS went for accreditation but after that there was a downtrend and the numbers started stagnating. Most of the smaller facilities faced difficulties in complying to the requirements laid down by the accreditation body. NABH felt that a smaller version needs to be introduced with reduced requirements so that the small and mid-sized facilities would also start going for accreditation, there by ensure atleast some basic quality of care to patients.

This article discusses whether introduction of Entry Level Accreditation has really increased the number of organisations seeking quality.    Read More

Pricing in private hospitals needs to be monitored: NIC chief

Source: The Hindu Business Line

Public sector insurer, National Insurance Company (NIC) on Wednesday made a strong pitch for monitoring pricing in private hospitals and a need for a regulator in this regard.

According to AV Girija Kumar, Chairman and Managing Director, NIC, there was a need to have a regulator who would monitor pricing in private hospitals and stop them from charging exorbitant rates.

“There is a need for monitoring pricing in private hospitals,” he told newspersons on the sidelines of an interactive session organised by the MCC Chamber of Commerce & Industry.

“Healthcare financing and delivery should be integrated and this will help the insured people immensely,” he added.

Tamilnadu mulls accreditation for hospitals offering health insurance

Source: The Hindu Business Line

Tamil Nadu plans to get hospitals offering healthcare services under the State-sponsored health insurance accredited for quality. The move is expected to help healthcare providers adopt standard operating procedures and free patients from needless expenditure necessitated by infection, wrong diagnosis and surgical errors.

The National Accreditation Board For Hospitals and Healthcare Providers will look at 149 objective parameters for entry-level acceptance for small hospitals. For hospitals with bed strength above 50, the board has set over 600 standards. Infection control, pharmacy management, care of patients and patient rights are among key benchmarks. Health centres need pay Rs.10,000 as certification fees, and State health officials are keen to get a good portion of the 834 government and private hospitals offering the insurance scheme.

J Radhakrishnan, Tamil Nadu Health Secretary, said smaller health centres should play a proactive role in getting their facilities accredited so that the scheme could expand further.

C Vijayabaskar, Health Minister, Tamil Nadu, said a meeting to discuss modalities of getting these hospitals accredited and estimate the associated expenditure will take place soon.

He added that the State health scheme has touched over seven lakh lives so far, spending close to Rs.1,509 crore since its inception in January 2012. Over 2.74 lakh patients have received life-saving surgeries at Government hospitals. The scheme has expanded its coverage to 1,016 diseases now, and is looking at including heart transplants.

Improved quality reduces large needless costs for all stakeholders – the insurer, the hospital and the State, said Somil Nagpal, a World Bank health specialist analysing Government health schemes in the country. He co-authored a report “Government-sponsored Health Insurance in India-Are you Covered?” It concluded saying a fourth of India’s population by 2010 was benefited by different ways from Government health schemes.

“Costs of excessive healthcare due to wrong diagnoses and mistakes during surgeries touched $41.5 billion in 2006, a number equal to total healthcare expenditure in India during the year,” he said, adding that the NABH has only 250 hospitals accredited in a country of over one lakh health centres.

Need for sound regulation to ensure provision of Quality Healthcare

May 29, 2014 by · Leave a Comment
Filed under: Events & Updates, Healthcare, Industry Update 

Source: Economic Times

Health minister Harsh Vardhan has reportedly said that the new government will give top priority to health insurance for all citizens. Universal health insurance is a flawed idea, and expensive too.

The premise that the government should pay for insurance and insurance spread will ensure healthcare is misplaced. The start of healthcare must be public health and nutrition. And the essentials are providing safe drinking water and hygienic disposal of human and animal waste. This, in turn, calls for fixing the deranged sanitation system that contaminates aquifers and spreads disease. The government’s focus should be on expanding sanitation programmes like Nirmal Gaon, involving local communities.

The lowest-cost healthcare would be the one delivered by state facilities without a profit motive. Private healthcare would entail actual cost plus a profit margin. When private healthcare is accessed via insurance, the premium would have to cover, apart from actual cost, two layers of profit: the private care providers’ and the insurers’.

Should the government bear this burden? The state should build its own care facilities. The second option is for the state to pay for managed healthcare, in which providers charge per capita to keep a group healthy, with an inbuilt incentive to keep costs down. The need is to have sound regulation to ensure provision of quality healthcare.

India needs a regulator for the health sector to bring in transparency in procedures and billing, and also promote ethical competition among hospitals. Narayana Hrudayalaya and Aravind Netralaya are sound examples of low-cost healthcare models that others should follow. The state must concentrate on own care facilities, effective regulation, expanding healthcare manpower and clean drinking water and sanitation.

Healthcare Marketing Value Factor Session 2: Note

October 1, 2013 by · Leave a Comment
Filed under: Events & Updates, Healthcare, Value Factor 

We take pleasure in informing you that the Value Factor session 2 was received well with a good audience turn out as usual. The session was anchored around a few topics like

  1. Whether hospitals can improve revenues using insurance route
  2. Whether hospital revenues were going up steadily or coming down through this avenue
  3. How hospitals have to gear up before they tap the full potential of insurance routes
  4. What types of procedures are clocking good numbers and revenue patterns over the years Read more

Value Factor Session 2

September 26, 2013 by · Leave a Comment
Filed under: Events, Value Factor 

Value Factor’s 2nd session is scheduled to take place on Friday, 27th of September 2013 from 2 pm to 5 pm at the Andhra Chamber of Commerce premises in Chennai. The session will be followed by high-tea. There is no registration charge  associated with this session.

The topic of discussion of the second session is “Tap the Potential of Insurance – one of the powerful channels in Healthcare Marketing”.

Read more

Medical concierge to your rescue

February 25, 2013 by · Leave a Comment
Filed under: Healthcare, Other Verticals in Healthcare 

When a Mumbai-based medical concierge services company arranged for a quick consultation with the cardiologist at Fortis for one of its customers in Delhi, it was just the beginning. The service didn’t stop there. After the customer, a patient, was discharged, the family wanted to have a qualified nurse to monitor the patient for a few more days. The company stepped in to suggest names of agencies which could provide these services. She got to make use of these services as her husband was a travel policyholder of ICICI Lombard, which offered these services free of cost to the policyholder’s family.


Providing contact details of medical services, fixing appointments with doctors, planning an abroad trip to get medical aid and arranging for accommodation are a few services that fall under the ambit of a medical concierge. Concierges which take charge of such details are also called medical facilitators.


This market is huge abroad. In India, it is yet to pick up in a big way. However, some institutions do offer medical concierge services in their own way. While wealth managers offer these end-to-end facilities under a common head of other concierge services, Sahara Care House and other medical centres offer it exclusively.


Non-resident Indians (NRIs) or foreigners who come to India for cheap medical facilities are the biggest target group for these services.


For instance, ICICI Lombard offers medical services only to their foreign travel policyholders. In other words, it takes care of the family of the insured in India, while the insured is travelling. Sanjay Dutta, head-customer service at ICICI Lombard, says, “This is a new facility offered to our travel policyholders and we realised there was an increasing need for this.”


While this is offered to the family of the insured, most needs arise out of emergency. “Personal care and quick assistance to patients are the need of the hour,” says Dutta.


In the case of a travel policy, a 30-year old travelling to Europe for 10 days will have to pay a premium of Rs 1,300 for a medical insurance of $100,000 (about Rs 54 Lakhs . This policyholder’s family can make use of the medical concierge services offered by the insurer. The insurer can help the family with medical information on the city or location including transport, documentation and local culture information. The insurer can also move the patient or the injured to a medical centre, with air or surface transport where needed.


Some private hospitals have started concierge desks, where packages can be bought for the patient. It could be basic offering such as a spa, gym or restaurant coupon to the patient’s family. For instance, Sahara’s hospital in Lucknow allows relatives to view and speak to the patient in the counselling room at the hospital without compromising on hygiene and sterility. For a Mumbai-based private hospital, such concierge packages start from Rs 10,000, which includes hospitality and wellness-related services.


Sahara Care House, an on line concierge portal, offers medical services under their healthcare services bracket. For instance, the website says their relationship ambassador recently helped a person through his by-pass surgery process, while his family was back in Australia.


A medical concierge is like a coin with two sides. Such services might be rendered coming out of a high net worth individual’s requirement or a patient who requires immediate attention. For instance, a person who needs to be admitted on an emergency basis and a father who wants to send across gifts and flowers to his child admitted in hospital.


With the increase in medical tourism in India, there is a need for such services. According to estimates, India’s share in the global medical tourism segment will reach around three per cent of GDP by end-2013. Major healthcare players in India such as Apollo and Fortis have reported that 10 per cent of their revenue comes from this segment. If medical tourism bridges problems such as lack of transparency in billing system, low patient flow, etc.  then there will gradually be more demand for medical concierge services.



Source : Business Standard dt February 25, 2013



Healthcare Insurance Fraud – An Insight | Dr Prem’s Health First Magazine – a subsite of DrPrem.com

May 17, 2012 by · Leave a Comment
Filed under: Uncategorized 

Healthcare Insurance Fraud – An Insight | Dr Prem’s Health First Magazine – a subsite of DrPrem.com.

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