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8 Dec

Reducing ‘Out-of-Pocket Medical Expenses’ through Embedded Finance

qubehealth.Healthcare financing

QubeHealth bridges the gap between what an Indian pays for their healthcare and what their health insurance actually covers.

Indians spend $45 billion every year on Out-of-Pocket Expenditure (OoPE) medical expenses. This is one of the largest healthcare spends in the World. The reason being employer led group insurance policy doesn’t cover many large medical expenses. Medical insurance in general doesn’t cover medical costs like OPD visits, small procedures, emergency hospitalization.

In an exclusive interview with the Financial Express Online, Chris George, co-founder & CEO, QubeHealth says, “With 2 out of 3 Indians being un-insured or under-insured, Out-of-Pocket Expenditure (OoPE) continues to rise every year. India will see tremendous growth in this sector over the next decade, riding on the back of massive OoPE on healthcare by Indians.  Our aim is to create an ecosystem to help Indians get not just access to best medical professionals but also funds for paying for treatments that are outside the insurance policies purview.” Excerpts

Founded in 2019 by Chris George and Gagan Kapur, Mumbai based Health Tech startup QubeHealth is addressing this need gap for 300 million employed Indians by providing them on tap funds to address medical expenses which are not covered in insurance plans. QubeHealth works with over 100 large companies and reaches 1,50,000 people, has tie ups with 11,000 hospitals, clinics and diagnostic centres across India.

How does Embedded Finance work in the Healthcare sector and its growth and challenges?

Embedded Finance connects lenders and healthcare providers, by allowing a healthcare recipient to pay for any health or medical service using a pre-approved, credit line, built into a seamless payment system, such as a card.

QubeHealth provides a solution to employed Indians through their employers that combines, 0% healthcare financing, insurance and a market place, wrapped into a patient-focused concierge experience, built on an asset and CAC light model.

QubeHealth platform provides employed Indians, easy one-click financing, lowest prices and a concierge service to manage the entire healthcare needs of their family.  It helps companies by managing their employee health benefits. Once a company switches, their employee healthcare management too switches to QubeHealth. Employees can also add their family members to get better services and pay for their entire healthcare spends through one platform. Employees retain their QubeHealth membership as they move jobs.

Challenges are limited by the ability to acquire quality users and a credible health provider network.

How is the market panning out? India has one of the highest levels of Out of Pocket Medical Expenditure (OoPE), please suggest what measures should be taken to reduce the OoPE?

OoPE continues to rise every year, with the NITI Aayog report for March 2021, listing this at $72 Billion – the amount that Indians paid from their pockets on healthcare. Rationalising medical prices, increase in Government spending on healthcare and access to healthcare financing means, including insurance are ways to reduce OoPE.

How OoPE in medical is pushing Indians under the poverty line?

Over 5.5 Crore Indians fell below poverty this year, accelerated by the pandemic. With limited public spending healthcare, private companies are trying their best to fill in the gap of providing quality healthcare. This leads to a rise in healthcare prices. Borrowing for healthcare is commonplace and it comes with either a financial expense or an emotional expense.

How important is it to have on tap medical funds?

It is extremely important. The number one fear when a family experiences a healthcare issue, is not if they have the best doctor or hospital; it is if they can afford to pay for care. Having access to worry-free medical funds goes a long way.

What are the trends you see emerging in a post pandemic healthcare sector?

A significant shift in awareness related to healthcare-risk. Among other things this has led to employees asking their employers about their health benefits and their group health insurance policies.

Insure-Tech and Embedded Finance in Healthcare are the two significant areas of shift we’re seeing globally.

What are the growth plans for the next 5 years?

Within the next five years, QubeHealth will have deployed $1 Billion in healthcare credit in the Indian market, impacting millions of households and their ability to pay for healthcare.

How do you foresee the growth of your sector in India?

Out-of-Pocket Expenditure (OoPE) on Healthcare in India continues to rise every year. From $45 Billion just a few years ago, to $72 Billion this year. Deploying capital to fund this OoPE means taking a slice of this market.

Which are your competitors in India both from organised and unorganized perspective?

Medical loans have been around for some time now, however the experience is riddled with inefficiencies and high friction. Unorganised lenders have used usurious lending to create multi-generational poverty. Any sophisticated, low-cost, and friction-experience will be better than choosing this as an option.

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Qube Health
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