Claims under government health insurance fell by 51% during COVID-19 lockdown

A study conducted by the National Health Authority of India (NHAI) has found that the nationwide lockdown imposed in March 2020 to curb the spread of coronavirus resulted in a massive fall in hospitalisations in India.

According to the findings of the study, the claims volume under the government-funded health insurance scheme was 51% lower in the 10 weeks of the lockdown compared to the 12 weeks prior to the lockdown. The decline in the claim value was even steeper at 76% during this period.

The study ‘Prime Minister-JAY (Public Healthcare Scheme) Under Lockdown: Evidence on Utilisation Trends’ was conducted from 1 January to 2 June 2020 and the final report was released on 18 June 2020. Cancer treatment and hospital childbirths were among the most severely affected healthcare services during the 10 weeks of the lockdown period. Cancer care declined by 64% and hospital childbirths came down by 26% which are major areas of concern according to the study.

Medical procedures, planned surgeries such as cataract operations and joint replacements suffered a decline of over 90%, while haemodialysis declined by only 6%. There was also a sharp fall in cardiovascular surgeries. The report said that the reason for the decline was that hospitals were preoccupied with COVID-19 preparations or caseloads resulting in fewer resources for non-COVID-19 cases. This may be particularly relevant in public hospitals, which have been the primary focus of the government insurance scheme.

Private hospitals possibly reduced services out of fear among health workers that they will become infected or among owners that their business outlook will be jeopardised if they are perceived to be treating COVID-19 patients. On the demand-side, the beneficiaries might have delayed or foregone treatment due to fear of infection at a hospital or their inability to reach hospitals due to public transport shutdowns and mobility constraints.

The report concludes that it is possible that intermittent tightening and loosening of pandemic suppression measures will be necessary for many months to come. Ensuring that these have the least possible impact on the non-COVID-19 health programmes will be an ongoing challenge that merits continued close monitoring.

Source: Asia Insurance Review