After enrolling members with the fulfilment of membership criteria set by the scheme, membership (or client) databases should be maintained to manage the operations. Due to likeliness of having high volume of data, it is highly recommended that the data should be maintained in a computerised system. The system should provide the scheme with statistics on its members and services.
Information that can be retrieved from membership database:
• Number of new members for a period
• Drop-out rate
• Membership composition (sex, age, occupation etc)
• Number of member enrolled per field worker
Information that can be retrieved from the benefit database:
• Rate of occurrence of a type of diagnosis
• Cost per service/per age/sex group per time period
• Number of hospitalisation days per admission
• Morbidity and mortality rates
• Health care expense per household per month
• Health care services utilization rate per member
Information that can be retrieved from the premium collection database:
• Frequency of payment of members
• Total of premiums paid over a period of time
• Defaulters and overdue premium
With the data, the scheme can identify trends for its planning projections, compare the health status of its members with that of the other population groups, manage membership status, analyse cost evolution, design more efficient marketing tools by knowing its members and perform a variety of other management functions
Customer Service
Even though the health micro-insurance schemes are non-profit organisations, it is important for them to view members as clients who are entitled to highest possible quality of service. Schemes should therefore consider customer service policies and staff training on issues such as facing dissatisfied member or explaining reasons for not covering certain services. There should be a very efficient way of receiving feedback, dissatisfaction or suggestions from members and non-members.
