Big data can cut cost of health care by 63 per cent, experts say

A file photo of Health Cabinet Secretary Siciliy Kariuki. /MONICAH MWANGI
A file photo of Health Cabinet Secretary Siciliy Kariuki. /MONICAH MWANGI

Kenya’s agenda for universal health care can be achieved faster with big data technology, industry players have said.

CarePay chief executive Kees Van Lede, while releasing a status update of the firm’s health mobile wallet M-Tiba in Nairobi, said technology can help reduce health costs by ridding the system of up to 63 per cent of bureaucracy and fraud in health insurance.

“Paper work involved in medical insurance procedures and slow payment of claims increase hospital bills by 25 per cent so as to allow agencies cover for risks, and this is burdening to patients,” Lede said.

He said M-Tiba, a mobile saving and health insurance wallet allows instant approvals and claims payment, cutting 30 per cent of administrative costs in health care.

“Technology is a sure bet in liberalising health insurance sector in Kenya even as the government plans to embark on universal health care. It is also a key agent in cutting fraud while ensuring efficiency,” Lede said.

A recent world health report by WHO has listed fraud as one of the top ten leading causes of inefficiency in healthcare.

According to the report, nearly 6.9 per cent of all healthcare expenditure is wasted in fraud with traditional fraud detection methods only uncovering about 10 per cent of losses.

Last year, the Insurance Regulatory Authority named health and motor as leading in insurance fraud in Kenya. The regulator gave an example where patients are subjected to unnecessary tests that have nothing to do with the treatment of what they are ailing from so that the health provider can bill the insurer.

Unlike conventional health cover where patients follow rules prescribed by hospitals and insurance firm, M-Tiba gives the user absolute freedom to choose beneficiaries, diseases to be covered and rights to approve or decline terms of service. M-Tiba is customer owned, liberal and instant.

It has no room for bureaucracy. So far, 1.2 million people have signed up on M-Tiba since inception, facilitating Sh600 million paid in hospital bills.

He added that at least 1400 private health facilities in 37 counties in the country are now on M-Tiba platform with plans to start enrolling public hospitals starting this year.