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Innovations and Barriers in Health Microinsurance

Examining innovative solutions to improve health microinsurance
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Microinsurance Innovation Facility's Briefing Note 5 discusses the challenges that limit the growth and impact of Health Microinsurance (HMI). It also presents innovations that may move the field forward, including collaboration with public programs. The note is based on a longer thematic study that included a literature review and expert interviews. It focuses on private sector HMI.

Research shows that access to HMI reduces out-of-pocket health expenses, improves access to quality health care for those who are insured, and stimulates health seeking behaviors. Many challenges limit the growth of HMI, despite these positive indicators. Designing valuable, sustainable HMI products is more complex than other types of microinsurance. It is difficult to control utilization, ensure that the services are appropriate, and mitigate the risk of fraud and irrational pricing. Further, health facilities in developing countries often deliver poor quality services, which lowers member satisfaction. Supply-side issues in HMI include capital constraints, insufficient enrollment, and operational inefficiency. Innovations that can improve the growth and impact of HMI include:

  • Expanding member benefits;
  • Overcoming low capacity to pay;
  • Improving efficiency to achieve larger scale;
  • Forging collaboration between public and private sectors.