Bajaj Finserv Health to invest Rs 1000 crore in new direct-to-consumer health administration model

Mumbai: Bajaj Finserv Health aims to flip around the health administration industry by adopting a direct-to-consumer approach. The company, which recently acquired Vidal, a third-party administrator, will invest Rs. 1,000 crore in products and technology, including the launch of 'Health Saathi' concierge services to assist policyholders with logistical support during hospitalization.

A subsidiary of Sanjiv Bajaj-led Bajaj Finserv, Bajaj Finserv Health acquired Vidal Health Care in April 2024. Speaking to TOI, Devang Mody, MD & CEO of Bajaj Finserv Health, said he anticipates the industry to move towards an open architecture that empowers customers with greater TPA selection choices.

According to Mody, there are challenges to providing a seamless healthcare experience, even for insured customers. These include paper-based systems causing inefficiencies and delays, limited customer awareness of TPA choice rights, and inadequate understanding of health insurance policy nuances, hindering informed decision-making.

"TPAs serve customers but are paid by insurance companies," Mody said , emphasizing the potential conflict between this structure and customer support. He points out that regulations allow customers to make TPA choices, but the distribution system has yet to evolve to facilitate informed choices.

The concierge service will aid in hospital selection, paperwork management, and treatment navigation, particularly for employees in new cities. Additionally, Bajaj Finserv Health will introduce a "value-based care" product for maternity, offering comprehensive support beyond financial reimbursement. The company is also investing in fraud detection technology to reduce costs and improve affordability, along with AI-powered engines to enhance services and trust.

Bajaj Finserv Health already has a network of over 100,000 doctors and 16,000 hospitals. This network helps to address out-of-pocket OPD expenses, processing 150,000 transactions a month, and align with NITI Aayog's National Digital Health Mission.

The acquisition of Vidal Health enhances its capabilities, bringing health administration expertise and allows the company to offer comprehensive healthcare services across OPD, wellness, and IPD. The digital platform integrates all key healthcare ecosystem players to make cashless healthcare accessible to all customers.