This case describes a unique insurance scheme in India called Krupa Arogya Suraksha, promoted by the Shree Krishna Arogya Trust. The product was designed with the aim of extending basic health coverage to the “base-of-the-pyramid” population at an affordable premium. The services were provided by Shree Krishna Hospital, of which the Trust was an associate. The Trust and the hospital were looking at a win-win situation: in providing modern health services to a larger, lower-income group, the facilities of the hospital would be better utilized. In the five years since the scheme’s creation, membership had increased threefold to 43,000. These members accounted for 13 per cent of patients treated by the hospital. Thus, the dual objectives of extending affordable health care to the lower-income segment and increased utilization of the hospital facilities had been achieved, to some extent. However, the Trust was unable to meet the cost of the health care offered under the scheme from the premiums collected and was dependent on donors to cover the difference. The Trust’s management was concerned about the sustainability of such an arrangement and was looking for ways to make the scheme pay for itself.
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