Case Study

MEDIPLUS Health Services - Nairobi, Kenya: Notes from a Visit 05-08 July 2002

Managing the provision of health insurance to the low-income market
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This paper presents a case study of ‘MediPlus’, a privately owned, for-profit health maintenance organization (HMO), operating in Kenya, and covering about 65,000 people countrywide.

The paper sates that:

  • Staying competitive is an important institutional value for MediPlus;
  • MediPlus provides informational packages on various health issues;
  • Its client database ensures that the treatment clients receive is consistent with the coverage they have purchased;
  • This also protects both the health care provider and the health scheme from fraud;
  • In setting prices for products, MediPlus considers the cost of treatment, international cost of drugs, fees for re-insurance, operation costs and a mark-up;
  • Team work is essential to MediPlus’s marketing strategy;
  • Its “open door policy” fosters a positive relationship with health care providers;
  • Corporate clients have expressed satisfaction with the convenience of providing employees with the health care plan.

The paper describes the background of MediPlus, and provides details about the product, its health promotion strategy, institutional structure, operations, management and governance, partnerships with providers, client satisfaction with the product, risk management, strengths, weaknesses, opportunities and threats.

It concludes by listing lessons from the study about the operations, marketing, accounting and partnerships of health insurance products.

About this Publication

By McCord, M. & Osinde, S.
Published