Oncology major HealthCare Global Enterprises (HCG) which is the largest network in South East Asia, said that any tinkering with cashless health insurance would only shift the burden on patients. Further, it opined that since only a small number of individual policy holders avail the health insurance service from its network, the impact on the hospital could be minimal.

HCG with a network of 18 centres provides comprehensive cancer care with advanced technologies including CyberKnife whose non-invasive procedure has been much-sought after by patients at different stages of the dreaded disease, till now has been offering insurance benefits.

Insurance companies currently cover all modalities of cancer care covering surgery, medicine and radiation. At all occasions, these health insurance companies were helpful in ensuring that the patient was protected when a claim was made. At our network hospitals, around 22 to 25 per cent of the total patients avail cashless benefit of which individual policy holders would account for around 5 per cent, Dinesh Madhavan, director, marketing, HCG told Pharmabiz.

Around 80 per cent of the insurance support is from the public health insurance providers, he added.

According to Madhavan, the public sector insurance companies through its Third Party Administrators (TPAs) had communicated its stance to HCG. The role of a TPA is to ensure that it is a win-win situation for all three parties: insurance companies, insured and service provider. Hospitals enter into an agreement with the TPA's after the tariffs are finalized. He also categorically stated there was no differential pricing for insured and non-insured patients across its network.

It may be noted that the cost of oncology care depends on the type of cancer, the stage of the disease and the treatment option available. Typically, it could range anywhere from Rs 50,000 to Rs 8 lakh.

Presently, it is only the public sector insurance companies that have taken a decision to tinker with cashless benefit offered but such action could be followed by the private sector insurance companies and this would not auger well for the individual patients as the payment burden would be enormous, said Madhavan.