Expanding Health Access

Enrolment of construction workers in an insurance program through eKure, a USAID-supported health platform. (Photograph courtesy Anshul Khurana)

The National Sample Survey data on household consumption related to health expenditure showed that over 80 percent of Indians don’t have health expenditure coverage. According to the survey, medical expenses for hospitalization are substantial. On average, a rural household spends Rs. 16,676 annually, while an urban household spends Rs. 26,475.

Samagra, an urban health project funded by U.S. Agency for International Development (USAID)/India, works on ensuring quality preventive, supportive and basic health care for the urban low-income population. Out-of-pocket expenses are one of the key barriers for this community in accessing health care, as insurance coverage is statistically low.

Under USAID’s project, Population Services International and Entitled Solutions Private Limited have developed eKure, a technology-enabled, comprehensive health platform with benefits like daily accident coverage, daily hospital cash benefits, teleconsultations, and annual health check-ups for contract workers and uninsured households.

“As USAID’s Samagra project worked on scalable solutions to reduce out-of-pocket expenditures, the project also identified vulnerable sub-groups that could be efficiently reached,” says Anshul Khurana, co-founder of Entitled Solutions. They found that nearly 10 million workers in urban India, who work on short-term contractual low-income jobs, are vulnerable, need health benefits, and are “typically connected via the employer or platform ecosystem since they are hired by temporary agencies for temporary jobs and can be best reached through their employers,” he says. With this section of the workforce expected to reach around 23.5 million by 2029-30, the urgent need for affordable medical care is clear.

Expanding health services

What sets eKure apart is its ability to create tailored products designed specifically for contract and low-income workers. These products are integrated with employer platforms, with the costs often covered by the employers themselves.

“The current offerings consist of a comprehensive subscription program that provides access to doctor consultations, prescribed diagnostics, and pharmacy services,” says Anuradha Jain, senior adviser, Health System Strengthening, USAID/India. Additionally, there are flexi-micro and group health insurance plans available, which cover both outpatient and inpatient services. eKure also assesses eligibility and facilitates access for government health insurance programs such as Pradhan Mantri Jan Arogya Yojana and the Employees State Insurance Corporation.

“eKure has established a strong network of service providers and labs, including hyperlocal networks, to provide tailored and cost-effective products that cater to the specific requirements of employers and workers,” she adds.

Tapping into the tech ties

eKure uses the employment ecosystem to create awareness via digital and onsite activities. It primarily uses WhatsApp for communication in multiple languages, alongside onsite activities and telephonic engagement. Through its partnerships with over 40 workforce platforms and associations, eKure has expanded its services to a wider population.

“eKure primarily operates on a business-to-business-to-consumer model and collaborates with staffing platforms, as well as employers who manage a significant network of blue-collar workers,” says Neeta Rao, senior health advisor at USAID/India. “We have nearly 100,000 enrollments, resulting in a response rate of approximately 20 percent.”

eKure serves as a comprehensive benefits platform that interfaces between health service providers and workers. “Health benefits in India, including insurance, teleconsultations and e-pharmacies, are now tech-enabled, and eKure has evolved as a comprehensive benefits platform,” she adds.

By utilizing a primarily digital approach to the challenges of providing care, USAID’s eKure has been able to minimize operation expenses, thereby providing care to a large group at very competitive prices. In addition, its flexi-payment options allow users to make small payments over time, making it possible to achieve comprehensive coverage with minimal upfront costs.

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