Health insurance schemes are spreading in lowand middle-income countries. However, they often fail to achieve scale as they lack the organisational, human and technological resources and capacities. On 11 September 2018, Swiss TPH participated in the DayOne Conference - "Shaping the Future of Health" in Basel, presenting on OpenIMIS, an open source health insurance management information system.
Every year, more than 150 million people face healthcare expenditures that are so high in relation to available income that it has a tragic effect on a household’s financial well-being. In the context of the 2030 Sustainable Development Agenda, important emphasis is placed on achieving Universal Health Coverage. In particular, many lowand middle-income countries are working to implement health insurance schemes that offer greater financial protection for their populations.
The DayOne Conference - "Shaping the Future of Health" on 11 September 2018 brought together speakers, healthcare innovators, patients and start-ups in Basel to discuss and shape the future of health. Swiss TPH, together with the Swiss Agency for Development and Cooperation (SDC) and Gesellschaft für Internationale Zusammenarbeit (GIZ) presented OpenIMIS and worked with participants to further shape the initiative.
Comprehensive health insurance solutions
OpenIMIS (Insurance Management Information System) is the first and only open source software that links patient, provider and payer data. The system is designed to manage any health insurance scheme, from enrolling patients to transmitting and processing claims and calculating reimbursements.
"Given the enormous heterogeneity of countries and health systems, it is difficult to develop insurance solutions that cater for all. Mandatory insurance systems often fail to have a substantive impact in countries with large informal sectors, while people may lack understanding or are otherwise unwilling to join voluntary schemes." said Helen Prytherch, Head of the Health Systems Support Unit at Swiss TPH. "OpenIMIS provides a solution by improving the management of insurances through efficient processes, high quality data, greater transparency and increased fraud controlled." said Prytherch.
Social health insurance at Swiss TPH
Swiss TPH supports the design and implementation of new insurance systems as well as the redesign of existing ones, specifically in lowand middle-income countries. In close collaboration with health authorities and decision-makers, Swiss TPH supports the implementation of insurance structures and processes, operating procedures, marketing strategies, provider management and payment mechanisms, product pricing, risk pooling arrangements and performance monitoring.