BOMBAY, India -- In the past three years, managed-care service organizations have changed the way corporate India handles employee healthcare benefits.
Clients ranging from IBM to Rupert Murdoch's Star TV get services such as claims management and settlement and access to a 24-hour telephone information service. They provide clients and their employees information on hospitals and providers who are part of their managed-care service organization network. More important, managed-care service organizations offer credit at hospitals in the network.
Indian private hospitals require patients to pay a large deposit upfront before they can be admitted. This poses a substantial obstacle in emergencies or if the family cannot come up with the cash.
By setting up a credit account for a company's employees, managed-care service organizations relieve families of the burden of raising money, and provide employers a credible employee benefit that they don't have to create themselves in-house.
The networks also offer extra benefits such as subsidized health checkups and preventive health workshops.
In the changed scenario of privatized insurance, managed-care service organizations believe they will provide the interface between small and big providers, insurers and corporations.
"The scope of (managed-care service organizations) is growing day by day. Corporations now value the service we provide in linking them up to a network of hospitals, getting them credit facilities and discounts from providers, processing their claims and working out appropriate insurance packages for them," says Gautam Mukherjee, marketing executive of Heritage Health Services. Heritage, a Calcutta-based managed-care service organization, has a network of 50 hospitals and about 30 client companies, including Mitsui, a Japanese engineering company.
"About five years ago, employee healthcare benefits were the last thing on human resources managers' minds," says S. Balachander, chief information officer of Sedgwick Parekh Health Management, a network based in Bombay. "Now, they consider healthcare benefits to be an important need to be managed well. It helps in retention of good employees as well."
"It's been very useful to us," adds Deepak Varma, assistant manager of administration at Sony Music, which teamed up two years ago with Paramount Healthcare Management, another Bombay-based managed-care service organization: "Paramount handles all the claims processing for our 100-odd employees across the country. It eases up our job in-house."
Sameer Vakil, vice president and country manager of MasterCard International, says, "Our tie-up with Sedgwick Parekh provides our employees with a comprehensive health program with facilities such as a help desk, ambulance services and credit facilities at hospitals. Our people matter to us, and so we feel it's worthwhile for a (corporation) to tie up with a managed-care organization."
The best recommendation for managed-care service organizations comes from Anupam Swarup, vice president of operations at Delhi-based Himachal Futuristic Communications, a telecommunications firm. Earlier, as a senior executive at IBM, Swarup was hospitalized for a planned neurosurgery. "Other companies are often at a loss at such situations if they haven't tied up with a provider. Luckily, IBM had a tie-up with Sedgwick Parekh, which had a whole provider network at its disposal. That made all the difference," Swarup says.
Sedgwick Parekh is a joint venture of Sedgwick Noble Lowdes of the United Kingdom, the largest employee-benefits consulting group in Europe. Sedgwick Parekh handles employee benefits for 92 companies, including such American firms as Coca-Cola India, Reebok and McKinsey & Co.
Now Swarup is making sure his organization also contracts with Sedgwick Parekh to offer similar benefits to employees. "On discharge, my bills were sent to me only for my signatures and then on to SP, which cleared the same immediately," Swarup says. "It was extremely heartening to avail of such a service in India carried out with such efficiency to the minutest details."
But managed-care service organizations now want to go beyond corporate clients. "The market is much wider," says Nimish Parekh, managing director of Sedgwick Parekh Health Management. "We want to tie up with affinity groups such as community organizations and professional groups such as chartered accountants and lawyers."
Paramount Healthcare has already made a start in that direction by roping in 30,000 members of an Ismaili Khoja group, an Islamic subsect in Bombay. Says Paramount's managing director, Nayan Shah, M.D.: "The future's bright for all of us."
Sameera Khan, a freelance writer in Bombay, writes about healthcare for such publications as The Times of India.