Ayushman Bharat and concepts of insurance

 

Many states have agreed to launch Ayushman Bharat through a trust model and not the insurance model

Nearly 500 million people or 40% of India’s population will have health insurance as the government gears up to launch Ayushman Bharat, a health policy for the under-privileged. Modalities with respect to its pricing are still being worked out, but the scheme will be financed by the centre and the state governments.

 

Many states have agreed to launch Ayushman Bharat through a trust model and not the insurance model.

Under the trust model, the premium will not be paid to an insurance company, but will be pooled into a trust. It is this trust that will manage and administer the health scheme and also pay the claims. Under the insurance model, the state will pay premiums to an insurance company just like you do to your health insurer. The onus will be on the insurer to administer and pay the claims.

Both insurance and trust models depend on two basic principles: pooling of risk and law of large number.

Pooling of risk

What are the chances of a theft occurring in the entire neighbourhood at once? Close to zero, but chances that one house gets robbed are much higher. Now imagine the entire neighbourhood gets together and pools money to insure themselves against the common threat of theft. So if one house gets burgled, the pool can compensate for that burglary. This is called pooling of risk. Here, the risk of an event is spread out among all the people facing the risk who are prepared to pay a small sum or premium to get protection from that risk.

Law of large numbers

But pooling of risk is just one part, it’s important for this pool to be large to avoid adverse selection and improve the predictability of a risky event actually taking place to be able to price the product right. This predictability increases as more people join the pool. This is called the law of large numbers. According to this law, the average of the results obtained from a large number of trials will be closer to the expected result. Insurers can predict risk more accurately through this law.

So the larger the sample size, the greater is the predictability for insurance—this also leads to pricing the risk right. This is what Ayushman Bharat model depends on given that it’s meant for 500 million people. Comparatively, till FY17, insurers covered about 100 million people, excluding government cover

Source-LiveMint

Date-28-08-2018

 

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HR pressured by job market to invest in wellness benefits

Dive Brief:

  • It’s an employees’ market, and employers are feeling pressured to up their benefits offerings in response, according to a new study from Wellable, a firm specializing in employee wellness. Wellable gathered responses from 105 employee wellness professionals.
  • Over one third (35%) of respondents said employers would spend more on wellness programs in 2018, while just 15% stated that they would decrease spending. Areas targeted for increased spending include telemedicine, mental health and financial wellness, while the opposite trend is predicted for health fairs, fitness classes, health coaching and health risk assessments, largely because these services are harder to scale and cost more per engaged employee, Wellable said.
  • Results also showed that, when determining benefits investment, 79% of respondents cited a competitive benefits plan as an influencer, and 77% cited cost. The least influential factor was healthcare reform; less than 50% of respondents expect to be significantly influenced by legislative activity from Congress, while 20% expect healthcare reform to have little influence on employers.

Dive Insight:

For wellness programs to be worth the investment, employers and workers must agree on the value and effectiveness of those programs. In a 2018 Willis Towers Watson study, more than half of employers believed their wellness programs were effective, while just 32% of employees agreed. The demand for financial wellness has increased, with money problems being a major source of stress and distraction for employees at work.

Employers also must factor in their wellness programs’ impact on recruitment, retention and engagement. Employees who generally are dissatisfied with their benefits will leave to work for an organization with better benefits. In fact, a 2018 Randstad U.S. survey showed that benefits can be a bigger employment draw than money; more than half of workers polled said they had left a job for one with better benefits.

Of course, return on investment (ROI) is a common test for wellness programs, and ROI measurements can be especially disappointing during the first year of implementation. One study released earlier this year showed no improvements in health behaviors, medical expenditures, employee productivity or self-reported health status after year one of an example program.

Employers must invest in the kind of wellness, or well-being, programs workers value most and avoid over-estimating the significance of these programs without proof of positive outcomes.

Source-HR Dive

Date-14-08-2018

Is HR doing enough to navigate the #MeToo world?

From compliance to the future of work, HR teams today are hit with a multitude of priorities.

In fact, addressing each one individually is an immense effort and likely beyond the capacity of any single HR team, according to Steve Reid, chief people and culture officer, oOh!media.

“The #MeToo scandal is a clear example of why HR should be primarily and obsessively focused on building culture,” Reid told HRD.

“A great culture promotes openness, inclusion, belonging, enables change and demands acceptable standards of behaviour.

“The question is: Is HR doing enough to create cultures that prevent these scandals in the first place? Maybe not.”

Jessica Ciccozzi, general manager people and capability, QinetiQ Pty Ltd, added that she is “acutely aware” that employees don’t always feel comfortable stepping forward to raise workplace harassment concerns.

“The #MeToo campaign provided us with a valuable platform to proactively discuss these issues more openly,” said Ciccozzi.

“It’s easy to become complacent, but we have a duty of care to ensure we are always focused on reviewing our workplaces, training, and frameworks.”

This requires a continuous, long-term strategy that is driven both top down and bottom up, requiring open and honest discussions, according to Ciccozzi.

It also requires all leaders to be engaged and communicating with their teams regularly on acceptable behaviours, even when problematic behaviours aren’t evident.

The #MeToo movement has swept the country over the past year and businesses all over the world have moved to improve their HR policies, according to Matt Paine, ICC Sydney’s director of human resources.

Indeed, Paine cited research by the Society for Human Resource Management which indicates that half of businesses surveyed have, or are planning to, make changes to policies to improve how their businesses manage harassment.

“This is an opportunity to take stock, to set up or reconsider processes,” said Paine.

“HR has a leading role in educating teams and creating safe places for everyone.

“It’s up to every one of us to ensure our people are aware of what’s ‘right’ and what’s ‘wrong’ in any work environment.”

 

Source: https://www.hcamag.com
Dated: 8th August 2018