Delhi, Andhra Pradesh, and Uttar Pradesh have emerged as regions with the highest increases in average treatment costs, according to Medi Assist’s newly released Indian Healthscape 2024 report. The findings reveal that respiratory disorders, cardiac conditions, and cancer are driving significant rises in healthcare expenses across the country.
The report, launched by Medi Assist, India’s leading health benefits administrator, offers a comprehensive analysis of rising hospitalisation costs, evolving demographic patterns, and the increasing burden of critical illnesses. It highlights the pressing challenges of medical inflation, while underscoring the need for accessible, affordable healthcare and improved patient outcomes.
Cancer has been identified as the fastest-growing ailment, with incidence rates increasing by 10 to 12 per cent annually. The data shows that the likelihood of being diagnosed with cancer rises sharply after the age of 40, with women experiencing a 1.2 to 1.5 times higher incidence rate compared to men.
Cardiac conditions have emerged as the second-highest contributor to both cost increases and incidence rates, predominantly affecting men over the age of 40. The findings indicate that men are 1.3 to 1.5 times more likely to be affected by cardiac issues than women. Group insurance policies were found to report a higher frequency of cardiac claims when compared to retail policies.
Respiratory ailments have led to a notable increase in average treatment costs, rising by 10 to 13 per cent year-on-year. Karnataka, Maharashtra, and the National Capital Region (NCR) recorded the highest spikes in costs associated with respiratory disorders. These conditions have also become the leading cause of hospitalisation among children.
Cataract treatments, meanwhile, have shown a consistent rise post-COVID and remain the most frequently performed surgery among senior citizens. Group policies demonstrated a higher rate of cataract claims compared to retail policies.
Regional analysis within the report indicates that Delhi, Maharashtra, Andhra Pradesh, Uttar Pradesh, and West Bengal have seen the highest increases in average hospitalisation costs. Specific cities such as Mumbai, Raigad, and Nashik in Maharashtra have experienced notable rises in costs related to cardiac treatments, respiratory conditions, and maternity care. Similarly, Guntur and Visakhapatnam in Andhra Pradesh, as well as Ghaziabad and Noida in Uttar Pradesh, were identified as hotspots for rising treatment expenses.
The report also sheds light on the issue of fraud, waste, and abuse within the health insurance sector. Document forgery, medically unnecessary treatments, and the non-disclosure of pre-existing conditions were found to be the primary tactics employed by bad actors. These fraudulent activities accounted for significant portions of detected cases, with Medi Assist’s award-winning AI-powered MAven Fraud Detection Engine achieving more than double the rate of malicious claim detection compared to previous benchmarks.
Dhruv Rastogi, Senior Vice President and Head of Data Science at Medi Assist, remarked on the importance of these findings, stating:
“Our analysis provides critical insights into the evolving health landscape, particularly concerning the rising incidence of critical illnesses and the associated financial burden. This data is pivotal for driving innovations in insurance products that improve outcomes while effectively managing costs. Medi Assist’s cutting-edge technology enables the seamless administration of flexible benefits such as outpatient services, top-up covers, wellness programmes, and routine health checks.”
Dr Vijay Sankaran, Chief Claims Officer at Medi Assist, commented on the growing costs of medical treatment, “We are acutely aware of the steep medical inflation across the country and have directed our efforts towards mitigating its effects. Medi Assist’s extensive network of hospitals plays a crucial role in offering competitive rates to insurers, ensuring members benefit from cashless convenience. Our portfolio has managed a yearly increase in claim amounts of 5 to 7 per cent, significantly below the national medical inflation rate of 10 to 13 per cent.”
