On the lines of 'Obamacare', the health insurance scheme launched by the US government in 2010, the government of India can think of introducing a health insurance programme targeting the poor, the disabled and the elderly citizens of the country, according to Timothy Buxton, senior manager, Episource, a healthcare KPO (knowledge process outsourcing) in California.

While speaking to Pharmabiz on the sidelines of a seminar organised by Episource India chapter in Chennai, he said the medical care scheme was introduced in the US through an act called Patient Protection and Affordable Care Act (PPACA) which provides health insurance to American citizens by two modes/ components, Medicare and Medicaid. Obamacare is also called PPACA (peepaaca).

Medicare is the programme providing payment for medical services to the elderly and disabled patients. Medicaid is funded by the US federal government and administered by each state providing payment for medical services to patients of poor financial status. Both are government sponsored programmes.

If health insurance policies like PPACA introduced in India, it will benefit more people in the country besides providing opportunities for the skilled Indians to work in the related areas of the scheme including medical coding. Further it will reduce the number of uninsured persons in the country. In America, the scheme reduces the number of uninsured and under-insured citizens and lowers the cost of healthcare.

When asked what the Indians can avail of the scheme, Buxton, the senior medical coder of Episource said, India can adapt a scheme like this or many facets of it can be replicated in the country in the Indian standpoint. He said a transition to ICD-10 (international classification of diseases) from the present ICD-9 coding system will take place in the US on October 1, 2014. ICD-10 is extremely specific and includes over 10x the codes of ICD-9. This will require increased time and attention on the part of all medical coders. Canada’s transition to ICD-10 yielded a 50 per cent loss in productivity, he said.

Earlier, while addressing an audience of health professionals and medical coders on ‘US health industry-2013 and beyond’, he said the US medical industry is one of the largest medical and healthcare industries in the world and it is estimated that more than 750,000 physicians  and 5200 hospitals contribute services to the people. The total healthcare expenditure was over 2.5 trillion dollars in 2012, and is expected to exceed three trillion dollars in 2014 and 4.8 trillion dollars by 2021. According to him, the healthcare industry in US is growing at a very high rate. But the growth provides many challenges and opportunities for professionals to contribute and succeed both in the US and abroad.

Even though the Obamacare is progressing well in America, there are government regulations that become challenges for the programs. All the patients, providers (hospitals) and payers (government and private insurance companies) should comply with the regulations of the US government. The regulations require compliance of formatting standards for transmitting healthcare information by electronic means, medical coding systems for healthcare information and protection of patient’s private health information from disclosure to unauthorized persons, he added.

He said India’s population of graduates in technical, life sciences and biotechnology fields are ideal candidates for Health Information Management (HIM) activities due to their analytical skills and general knowledge. A subset of HIM is medical coding, the translation of descriptive medical information into alphanumeric codes to act as a common language across all parts of the US Healthcare system.