Insurers adopt telehealth to widen access to healthcare

But there is little or no legal framework for telehealth in most Sub-Saharan African states

Kamapal, Uganda | ISAAC KHISA | Globally, insurers have been perceived as slow to evolve and embrace innovation. But the coronavirus pandemic is flipping the narrative, as some insurers rapidly innovate to help consumers manage risks and protect against losses.

One such innovation; is providing telehealth services in partnership with healthcare providers to their clients subscribed to health insurance as coronavirus pandemic wreaks havoc across various sectors.

For more than a year now, seven insurance giants and a Health Membership Organisation– UAP Old Mutual, Jubilee, Liberty, Sanlam, Prudential, GA Uganda, Insurance Company of East Africa and AAR –have rolled out telehealth services, allowing the partnering health care provider, Rocket Health Clinic, to bill them for services rendered to their clients via mobile phones.

The services rendered here includes; patients’ access to medical doctors 24/7 via toll free phone calls or WhatsApp for consultation, patients sample collection from their preferred locations for laboratory tests and medicines delivery within Kampala.

Also, a special arrangement has been added for patients with chronic conditions such as Type 2 diabetes and hypertension to enable them access medicines and regular health check-ups without having to travel to the health facility.

Paul Kavuma, the chief executive officer at the Uganda Insurers Association (UIA), the apex body that brings together the country’s 29 insurers, reinsurance and HMOs told The Independent in an interview that COVID-19 triggered the new innovation to help their health insurance clients’ access health care services.

“We needed this innovation now than ever because the interface of our clients with the health care providers was a challenge since the government imposed restrictions on movement to curb spread of COVID-19,” Kavuma said.

“So, once we tested the product and found out that it was working efficiently…we said we had found a solution.”

Kavuma said, it is surprising that telehealth services appears to be cheaper to the industry as a result of standardized consultation fees and price of medicines.

This is the first time that the country’s insurers have moved past the government’s overall duty to come up with an enabling regulation to support the operationalization of some services such as telehealth.

The private sector health care providers and the government have in the past three-four years squabbled over the need for telehealth regulation, but they have all fallen short of drafting one.

Dr. Davis Musinguzi, the managing director of The Medical Concierge Group, the service provider of Rocket Health Clinic said patients interested in tele-consultations has been on the increase since the outbreak of the pandemic last year as more people stay away from hospitals, now marked as hotspots for possible spread of COVID-19.

He said the demand for tele-consultation services at Rocket Health Clinic grew nearly five-fold in 2020 compared with the previous year. The patients using the medical insurance rather than cash in payment for the services rendered to them grew nearly nine-fold during the same period under review.

This rhymes with the current statistics at the industry regulator, Insurance Regulatory Authority of Uganda, which indicates that insurers recorded a sharp growth in gross written premiums in health and medical insurance policies from merely Shs12.5bn in 2014 to Shs36.2bn in 2019 due to surge in demand.

However, insurance penetration remains at less than 1% compared to the African continent’s average of an estimated 3%.

“The long-term goal and vision of Rocket Health are to be the leading world-class digital health company in Africa,” Dr. Musinguzi said.

“Throughout the pandemic period, telemedicine has proven to be the future of healthcare. The Covid-19 pandemic has shown us that everything that we can routinely access physically, we should be able to access virtually.”

Insurers offering telehealth services in Africa

Telehealth, which involves speaking to a doctor or nurse through a secure audio or video connection, has been around for years and even growing prior to the pandemic but it is yet to be fully utilized in many African countries.

The absence of policy and political will, inadequate funding, cost of sustenance of telehealth services, patient and healthcare personnel bias on telehealth and willingness to pay, are to blame for the low adoption. This is according to the recently published study co-authored by Dolapo Babalola called ‘Telehealth during COVID-19: why Sub-Saharan Africa is yet to log-in to virtual healthcare?’

This state of affairs, according to insurance industry experts, has not only limited the population’s access to medical care due to acute shortage of trained healthcare professionals especially in remote areas but also slowed insurers in coming up with health and medical insurance products that matches with innovations. Many African countries spend less than 10% of their Gross Domestic Product on health care system.

Beyond Uganda, limited number of insurers are offering telehealth services to the population to boost health care access across the African continent.

Britam has partnered with Strathmore Business School in Nairobi, Kenya, to unveil telehealth services, dubbed Britam Afya Mikononi, to provide its clients with remote healthcare via their mobile phones, tablet or laptops, during the Covid-19 pandemic. The service is accessible to existing microinsurance and corporate medical covered customers on an outpatient basis.

Similarly, UAP Old Mutual insurance unveiled a similar service in the east African country under the medical cover to support its customers during this COVID-19 period and beyond. The new services include; delivery of drugs, tele counseling services, and telemedicine services.

BIMA, a startup that provides life and health insurance policies, along with telemedicine to support the latter, all via a mobile-first platform targeting consumers in emerging markets whose primary entry point to online services is via phones, not computers, is now active in 10 countries including Tanzania, Ghana, and Senegal in Africa.

The company also serves citizens of Bangladesh, Cambodia, Indonesia, Malaysia, Pakistan, Philippines and Sri Lanka across Asia. BIMA’s executives also says they have clocked two million tele-doctor consultations, with some 35 million insurance and health policies.

“Telemedicine and insurance are needed more than ever and COVID accelerated awareness and acceptance for these types of products amongst emerging consumers and government. They’ve gone from ‘nice to have’ to a necessity,” Mathilda Strom, who co-founded the company with CEO Gustaf Agartson, told the techcrunch.com in an interview.  “Utilisation nearly doubled in our telemedicine services.”