Narayana Hrudayalaya’s ‘Aditi’ – the Latest Experiment in Indian Healthcare
In an innovative leap forward for Indian healthcare, Narayana Hrudayalaya (NHL), a Bengaluru-based hospital chain, has launched the Aditi insurance scheme. This initiative, under the umbrella of Narayana Health Insurance, marks a significant departure from conventional healthcare insurance offerings, with its surprisingly affordable annual premium of Rs 10,000 for a family of four. This covers Rs 1 crore for surgeries and Rs 5 lakh for medical treatments exclusively within the NHL network of hospitals.
The Aditi scheme, initially rolled out in Mysuru, employs the ‘managed care’ model. This approach to healthcare aims to provide subsidized costs to those enrolled in insurance plans or membership programs. Managed care has seen various degrees of success globally, with notable implementations in the US by hospital chains like Kaiser Permanente, Geisinger Health System, and Intermountain Healthcare. Even within India, the Bengaluru-based healthcare startup Even has offered a managed care plan to its members, emphasizing the model’s potential viability and benefit to the Indian healthcare landscape.
The managed care model emerges as a solution to the issues plaguing conventional health insurance schemes that incorporate an open network of hospitals. Under these traditional schemes, insurance companies struggle to standardize room rates and prevent unnecessary treatments due to their inability to exert control over the disparate array of hospitals within their network. Managed care, by contrast, restricts its network to a select group of hospitals, thereby ensuring cost control, preventing over-treatment, and potentially reducing the overall cost of medical care for the insured.
However, this model is not without its limitations. It restricts patients’ ability to seek treatment outside the network, barring emergencies, and might not be suitable for large corporations needing to provide nationwide health insurance benefits to their employees. Furthermore, there are inherent governance challenges, including the potential for conflicts of interest when the care provider is also the insurer, which might lead to under-provision of care as a cost-saving measure. Nonetheless, for an established network like Narayana Hrudayalaya, which boasts 21 hospitals across India, these challenges are not insurmountable.
The Aditi scheme by NHL is primarily aimed at middle-class households. These families often fall through the cracks of the healthcare system, earning too much to qualify for government schemes like Ayushman Bharat, yet finding the high premiums and co-pays of private health insurance beyond their reach. NHL’s initiative represents an attempt to fill this gap, offering an affordable healthcare option to a significant segment of the Indian population.
The introduction of such a model underscores the need for diverse healthcare delivery models in India. With a vast and varied population, a one-size-fits-all approach to healthcare is both impractical and insufficient. Innovations like the Aditi scheme by Narayana Hrudayalaya are critical in the evolution of the Indian healthcare industry, affording more individuals access to affordable and effective medical care.
As the Aditi insurance scheme takes its first steps in Mysuru, its success could herald a new era for healthcare in India, one where quality medical care is no longer a distant dream for the average Indian family but a readily accessible reality.
