What you need to know:
- Moses Kuria: In Kenya, almost a million people are pushed into poverty every year due to healthcare spending.
Health insurance has in the past been elusive for many Kenyans, but thanks to technology, patients can now access healthcare through faster claims processes.
The rise of insurtech start-ups in Kenya has done away with the traditional voluminous paperwork, while helping low-income families access cover through affordable premiums.
One of the leading start-ups in this space is M-Tiba, which was established in 2015. It has enrolled more than 4.7 million users across Africa and handles over one billion transactions through more than 3,100 healthcare providers. Moses Kuria, the Managing Director at M-Tiba, speaks about the journey of transforming access to health insurance over the past seven years.
How does the M-Tiba platform work?
In Kenya, almost a million people are pushed into poverty every year due to healthcare spending. We know that about two out of every five Kenyans are not able to access healthcare when they need it, and this is simply because they cannot afford it. So, seven years ago, we started M-Tiba to address this gap by making healthcare more affordable and accessible to the masses.
Through leveraging technology, we looked at what Safaricom had done with M-Pesa and came up with a platform that connects healthcare providers, insurers and members. By introducing trust in the interactions of these groups, we create transparency for insurers and healthcare providers, and more importantly empower members to access and manage their health insurance and plans.
How many insurance providers are on M-Tiba right now?
Currently, we have partnered with more than 20 payers, both insurance companies and donor institutions. We have also partnered with more than 4,200 healthcare providers who administer care to our members.
When we first launched, we had only partnered with one payer. The reception of M-Tiba by the masses precipitated an entire shift not only for us but for the entire healthcare business; we had earned the trust of majority of Kenyans and this allowed us to easily grow and engage more partners.
There is competition in this space. What makes M-Tiba stand out?
M-Tiba’s main aim is to democratise healthcare and enable the uninsured population, which currently stands at almost 98 per cent, to access care.
As a digital connector of the healthcare payers, providers and members, we are covering the healthcare journey end-to-end, allowing us to tap into all issues – hospitals are paid much faster and insurers can develop affordable products. Our members are able to get insights into their cover limits and the hospitals they can access, check their balances and directly manage their health covers. This creates a high level of transparency and trust across board.
Insurance fraud is a huge problem in Kenya, how does M-Tiba minimise this?
M-Tiba’s platform improves the way money flows through the healthcare system, thus lowering the costs people must pay to get access to good quality healthcare. As all transactions and related information flows are handled in real-time in the cloud, administration costs resulting from manual processing are lowered drastically. This way, we reduce the unaccounted costs that are often caused by fraud.
Data informs us every day. We learn, process and improve the value we offer by using data-driven insights. Not just for our core – the M-TIBA platform – but also to provide hospitals with valuable information that was previously unavailable to them due to manual processing. Growing our connected healthcare network means growing the ecosystem for the benefit of the members.
What is Off M-Tiba?
At M-Tiba we are always simplifying the complex, we want people to be empowered to access the treatment they need when they visit a doctor, as easily as they do when they walk to an M-Pesa agent to withdraw or deposit money. With a simplified USSD process, whether one has a feature phone or a smartphone, members can dial *253# and sign up on M-Tiba and buy a plan that suits them.
This enables them to get treatment, find a clinic closer to them and even manage and have an insight on their benefits and recurring balances, that way their members get the transparency they need on their health spend, make decisions that protect their livelihoods and stay in control.
What is the most affordable insurance plan on the platform and how can Kenyans start saving for this?
Through our partnership with various insurers, we have been able to come up with negotiated and discounted plans. We have insurance products that are priced at Sh4,600 per year, which is Sh383 per month. So, roughly, if someone can put aside Sh12 to Sh15 every day, they can be insured for an entire year.
We believe that by checking on the cost factor in health insurance, we will enable even more people to be covered.
How does cash advance on the M-Tiba platform work?
Cash advance is a short-term digital loan offered by the Medical Credit Fund through M-Tiba. We enable healthcare facilities, that is, hospitals, pharmacies, clinics and specialists, to access no-collateral and low interest financing of up to Sh40 million to cover their operational needs or support their expansion plans.
We operate through a Lipa na M-Pesa till transactional approach, where we agree with the facilities on a flexible repayment plan. The facilities determine what percentage of their earnings will go towards the repayment of the loans. Through this, the facilities can offer better care to patients and grow sustainably.
More than 600 facilities have benefited from cash advance; we have offered roughly more than 5,000 working capital financing, thanks to this partnership.
What more should we expect from M-TIBA in 2023?
At M-Tiba, our mission remains to ensure that a greater proportion of the 98 per cent of Kenyans not insured have some form of health protection and can access the care they need.
All our efforts remain geared towards this; we would like to reach even more people. Currently, 4.7 million people have trusted us with their health, we would like to grow to 10 million members in the coming years, and enable even more people to conveniently access affordable and quality healthcare when they need it.