Insurers and private hospitals should formulate policy to address concerns of all stakeholders in India, says GlobalData

The Insurance Regulatory Development Authority of India (IRDAI), insurance companies and private hospitals should come together to formulate a policy that addresses the concerns of all the stakeholders and does not impact the quality of surgical treatment in India, says GlobalData, a leading data and analytics company.

Recently, insurers and third-party administrators (TPAs) in India have come together to standardize the prices of common surgical procedures such as angioplasty, kidney transplantation, cataract and hernia with a view to ultimately help both patients and insurance companies.

The company’s report, ‘Access Instruments – General Surgery Market Analysis and Forecast Model’, reveals that the number of surgical procedures in India is expected to grow at a compound annual growth rate of 11.85% for the period 2019-2028.

Rohit Anand, Medical Devices Analyst at GlobalData, comments: “A majority of the public sector and few private insurers have standardized the prices of most of the common surgical procedures by setting up a preferred partner network of hospitals. However, a large number of private hospitals are yet to join these networks as they believe that this will impact their business growth and sustainability. On the other hand, insurance companies blame private hospitals of arbitrary pricing.”

Currently, there are disparities in the pricing of surgical procedures by private healthcare facilities. A common procedure cost in India varies a lot depending on the type of hospital, treatment, doctor and location.

Progressive hike in the cost of surgical procedures by private sector hospitals will continue to put a burden on policyholders and patients have to bear more out-of-pocket expenses despite having insurance.

Anand concludes: “A customer-centric policy will encourage a large part of the Indian population to buy health insurance and this will in turn benefit both patients and insurers.”

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