Updated Mar 12, 2019

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CarePay Ltd

CarePay has developed a mobile Health platform that connect payers and providers of Healthcare to beneficiaries who can save, receive and spend funds on Healthcare services and Health Insurance Premiums.

https://www.carepay.co.ke/
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Shah Priya

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Stage 5: Scaling

Focus Areas:

Health and Digital Inclusion & Connectivity

Health and Digital Inclusion & ConnectivitySEE LESS

Implemented In:

Tanzania and Nigeria

Tanzania and NigeriaSEE LESS

500,000
Lives Impacted to Date
2
Countries Implemented In
4,100,000
Customers
77
Employee

Problem

Less than one in five Kenyans enjoy some form of medical cover. This is mainly attributed to the increasing cost of care and the lack of trust between insurance providers, providers and consumers. Every year, about 1.5 million Kenyans are pushed below the poverty line due to catastrophic Healthcare costs . Insurance providers have been unsuccessful in scaling affordable medical insurance covers due to the high administration costs, increasing levels of fraud and the escalating cost of Healthcare. The situation in the other markets where CarePay currently is active in (Nigeria and Tanzania) is similar, if not worse. The highly manual claims submission processes make it impossible to take prompt actions due to lack of real-time data. It is estimated that as much as 50 per cent of insurance claims paid out are actually-falsified iii. Delays in payment, on the fee for service model, have further incentivized Healthcare providers towards over-utilization and increasing service costs. Insurers in return, in a bid to manage escalating costs, have increased premiums to allow them to deploy biometric and utilization monitoring technology to manage the highly complex benefit restrictions.

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Solution

Through CarePay’s M-TIBA platform, funds from Donors, Public and Private insurers are directed to consumers Mobile Health wallet making them much more involved and aware of the cost and quality of care they receive. The funds can be restricted to conditional spending at selected healthcare providers. With every transaction, CarePay can offer a digital payment for real-time medical and financial data, making healthcare more transparent for patients, healthcare providers and Payers. The real time data available to insurers should help improve their pricing strategy and their ability to pay providers promptly. In addition, using machine learning and artificial intelligence, the platform aims to automate claims management, prevent fraud, and shift the focus away from fee for service models towards rewarding providers for outcomes and quality care. Competition exists in specific segments, but no player is offering a holistic solution across the entire customer journey. The use of the mobile phone to manage benefits also fosters a closer relationship with every consumer creating opportunities for behavioral change and increasing the focus on preventative care

Target Beneficiaries

The platform accommodates all users as our aim is to be able to give everyone improved access to Healthcare. The key difference is in how we engage with each of these groups of beneficiaries both in terms of the technology and products they may be enrolled onto why the platform. The lower incomes benefit from donor funded projects while the middle- and high-income groups are in corporate or Insurance programs that also run on our platform. For the Universal Healthcare project the system has used a means mapping survey to help identity the vulnerable in the community with the aim of making it possible to have government or donors pay for their Healthcare insurance premiums.

Mission and Vision

Giving everyone everywhere the power to Care.

Innovation Description

Through CarePay’s M-TIBA platform, funds from Donors, Public and Private insurers are directed to consumers Mobile Health wallet making them much more involved and aware of the cost and quality of care they receive. The funds can be restricted to conditional spending at selected healthcare providers. With every transaction, CarePay can offer a digital payment for real-time medical and financial data, making healthcare more transparent for patients, healthcare providers and Payers.

Competitive Advantage

With the use of the CarePay platform, cost of administration per life has been shown to be reduced by more 50%. The cost of medical care on schemes has also been reduced by as much as 20% annually. Additional cost savings whilst enhancing the quality of care has been shown using additional tools that track patient journeys allowing for better capitation models and other smart re-imbursement and contracting models for care.
New Implemented CountriesGhana
Recruit10 management 5 board members
New FeatureDisease tracking apps and other Data propositions

The Team Behind the Innovation

The Carepay leadership is very dynamic and Diverse. We have has

Milestones

Dec 2018
New Country Implemented In
Nigeria
Oct 2018
Recognition ReceivedPENDING
Aug 2017
Recognition ReceivedPENDING
Apr 2017
Lives Impacted
500,000
Dec 2015
Created