Even is a monthly membership which gives you all-in-one health cover at the top hospitals in the country.
Unlimited diagnostics, consultations, and 50 lakh worth of hospitalisations.
Why are we doing this?
We want to fix health insurance. No more nasty surprises with complicated policies full of exclusions, denied claims, or time-consuming reimbursement processes.
Roughly 50% of customers are not satisfied with their health insurance, and 60-70% are unhappy with the exclusions and claim settlement process of their policy¹. To make things worse, on average, customers only get back 76% of their claim amount². There has to be a better way. We don’t have to give all the power to insurance companies.
We let doctors, not insurers, decide what treatment we really need and we reward hospitals for keeping us healthy, not for carrying out the most expensive procedures.
This means that if your doctor says you need something, it’s covered, and that your membership’s money goes to our partner hospitals no matter what- even if everyone is healthy and no costly operations are carried out. The hospitals that treat our members and keep them healthy simply get more money.
In one sentence: more inclusive cover for you and better incentives for hospitals that will do their best to make sure you stay healthy.
How it actually works
We are addressing the broken incentives at the heart of health insurance.
To do this, we are partnering with the top hospitals in India and offering them a simple proposition:
Take on risk, get the profits.
That means hospitals are now the ones guaranteeing care to our members. There's no insurer involved and therefore no conflict of interest with hospitals or customers. Incentives are flipped:
- No incentive to deny claims. Hospitals get paid for the procedures they carry out, they don't lose money like insurers would.
- No incentive to extend hospital stays, carry out the most expensive procedure, or over-treat regardless of outcomes. If hospitals can effectively reduce costs, they keep the savings.
- A new incentive to keep patients healthy by doing more preventive care. This reduces costs for hospitals in the long run and keeps our members happy with their cover.
Let's break these down.
When an Even member gets treated, the treating hospital gets reimbursed at a negotiated rate that's intended to cover the costs to the hospital, without an excessive profit margin which would incentivise over-treatment. Once all hospitals are reimbursed for the operations carried out in a given period, any leftovers from our membership money (minus Even's fixed share) are redistributed among our partner hospitals. These are the "profits" and, crucially, hospitals that treat more of our members get a larger share of these profits.
This way we encourage hospitals to treat our members (they get nothing if they don't), without also encouraging them to inflate expenses or commit fraud. It makes more sense for hospitals to reduce costs and increase leftovers than carry out unnecessary procedures. In the long run, what will save costs the most is keeping our members healthy. That's why we can cover consultations and diagnostics: we want to detect early and prevent. Patient well-being and hospital incentives are now aligned.
So, finally, as a member, this means you can get affordable access to the highest level of care without having to worry about exclusions, room rents, deductibles, or co-pay. Everything is cashless: you show up at one of our partner hospitals, get the treatment the doctor recommends, and go home. No bill, no claims process.
We are firm believers that the quality of the team determines the success of the company. What makes a great team? We'd say: great people and a great work environment. That's why we have put forward an ambitious goal for the months to come:
Create the environment where you can do your best work so far.
It's hard to define "best", but we’d like Even to be a place where you feel you do meaningful work. Work which makes a tangible difference to our wider mission and that you enjoy doing.
The "so far" bit is also important. Building Even may not be your life goal and we understand that. Some in our team may want to start their own companies (it's been known to happen...), some may go off and pursue other passions, and, if we deliver on our mission, some of our early team members may never have to work again. Wherever life may take you, we aim to be the kind of place you'll take with you, replicating our practices and principles elsewhere.
Now that you know a little bit about what we are trying to achieve and how, it makes sense to lay out the process of joining Even and what working with us will actually be like if you join. We’re an early-stage startup so things may change and a lot still needs to be figured out, but broadly the following sections outline what to expect:
² IRDAI Annual Report 2018-2019.