PharmAccess signed a US$ 250,000 grant agreement with the International Labour Organization in Geneva on October 2011, on behalf of the mini-consortium PharmAccess/Hygeia Community Health Plan. The Grant Agreement is initiated by the Micro-insurance Innovation Facility, one of International Labour Organization (ILO) departments. This facility seeks to increase the availability of quality insurance for the development of the world’s low-income families to help them guard against risk and overcome poverty. The Facility was launched in 2008 with the support of a grant from the Bill & Melinda Gates Foundation. In December 2010, the Micro-insurance Innovation Facility issued round 5 applications for grants for innovation in micro insurance, focusing on efficiency and scale. PharmAccess and Hygeia Community Health Plan proudly received a new grantee certificate at the fourth Micro-insurance Innovation Forum in Rio de Janeiro.
The ILO grant agreement will be used to implement technical solutions to improve the Hygeia Community Health Plan (HCHP).The Hygeia Community Health Plan offers health insurance to a low income target group in Lagos and in Kwara State. HCHP is implemented by Hygeia Nigeria Limited, the local implementing partner of the Health Insurance Fund and PharmAccess. The Hygeia Community Health Plan scheme is confronted with challenges in policy administration (premium collection, enrolment, client identification), utilization data reporting and claims management processes largely due to manual processes and limited automation. These circumstances lead to higher incidence of benefit leakage, fraud, and reduce value for clients (who then are less inclined to enroll or renew).
To address these challenges, Hygeia plans to implement several technology and process improvements. To address problems with identification and fraud, Hygeia plans to deploy a biometric enrolment system. Staff will be able to use point-of-sales terminals to capture biometric information from clients during enrolment that can be verified by health providers when clients access health care.
The Hygeia Community Health Plan will also implement a mobile-based payment system to improve renewals. The main cause of low renewals is the lack of convenient access for clients to sales points. Using the mobile-based payment system enables clients to renew their policies.
To improve claims turnaround, HCHP plans to implement a GPRS-enabled utilization and claims management system. The system will allow HCHP to consolidate more quickly and dispatch the utilization and claims data to the insurer for prompt processing and payment.
The interventions are planned to be rolled out in a 3-year period starting in the fourth quarter of 2011.