MEDI ASSIST HEALTH SERVICESMedi Assist Healthcare Services Limited is a health-tech and insurance-tech company that manages health benefits for employers, retail members, and public health schemes, primarily serving insurance companies.
Company provides third-party administration (TPA) services to insurance companies through its wholly-owned Subsidiaries, Medi Assist TPA, Medvantage TPA, and Raksha TPA. A third-party administrator is an organization that processes health insurance claims for insurance companies and provides services such as policy administration, customer service, and network management, among others.
As of 2023, company collaborated with 35 insurance companies in India and globally. In FY23, company managed a CAGR of 35.67%. The group accounts portfolio as a percentage of revenue from contracts with customers was 72.19% and the retail portfolio was 10.98%.
Company also acts as a facilitator between (a) insurance companies and their policyholders, (b) insurance companies and healthcare providers (such as hospitals), and (c) the Government and beneficiaries of public health schemes.
Company serviced over 9500 group accounts across sectors to help administer the insurance requirements of their employees. It held a significant share of the total health insurance market for group accounts, representing 26.39% of India’s overall group health insurance market in FY23.
Company also services individual insurance policyholders, and for FY23 it managed Rs 17.57 billion of premiums for the retail health insurance market, representing 5.06% of the overall retail health insurance market in India.
In H1FY24, company helped settle 3.05 million claims, comprising 1.37 million in-patient claims and 1.68 million domiciliary or out-patient claims.
Medi assist also facilitates other healthcare and ancillary services such as hospitalization services, call center services, customer relations and contract management services, billing services, and claims processing services through its Company and other Subsidiaries, IHMS, Mayfair India, Mayfair UK, Mayfair Group Holding, Mayfair Philippines, and Mayfair Singapore.
Company has developed a pan-India healthcare provider network, which comprises 18,754 hospitals across 1,069 cities and towns and 31 states (including union territories) in India and a network across 141 countries globally, as of 2023. Company intends to pursue acquisition opportunities to expand its existing service offerings, increase market share in existing markets, and expand to new geographies. In the last eight years, company has completed several acquisitions, including the acquisition of Dedicated Healthcare Services TPA (India), Medicare Insurance TPA Services (India), IHMS, Mayfair India, Medvantage TPA, and Raksha Health Insurance TPA.
Financial Performance:
- Total premiums under management administered by the company was at Rs. 19,050 crores as of March 31, 2024, showing a growth of 30.7% over the previous year.
- Group segment fund was Rs. 16,709 crores, with a growth of 30.4% year-on-year.
- Retail segment stood at Rs. 2,341 crores, showing a growth of 33.2% year-on-year.
- Company's share of the total health insurance industry premium was at 19.6%, with a growth of 186 basis points over the previous year.
Operational Highlights:
- Maintained group account retention at 94.7%.
- Processed 3.6 million outpatient claims in the last year.
- Won an award for "Best use of AI in Healthcare" for the Fraud Detection Engine.
- Continuing to invest in preventing fraud, waste, and abuse in the system.
- Building a team of data scientists for better data security and analytics.
Financials:
- Total income for the quarter ended March 31, 2024, was Rs. 171 crores, showing a growth of 23% year-on-year.
- EBITDA for the quarter was INR 37 crores, with a margin of 22% on operating revenue.
- Profit after tax stood at Rs. 25 crores, showing a growth of 50% year-on-year.
- Total income for the year ended March 2024 was Rs. 653 crores, with a growth of 26% over the previous year.
- EBITDA for the year was Rs. 133 crores, with a margin of 21% on the operating revenue.
- Profit for the period, adjusting for exceptional items, was Rs. 92 crores, showing a growth of 22% year-on-year.
Technology and Investment:
- Investing around 3-4% of revenues every year in technology.
Total investment in the platform and capitalization as of March 31, 2024, was Rs. 10 crores.
- Investing in a platform for the UK, with an expected cost of around 8 crores.
Future Outlook:
- Expecting to bring the acquisitions to the company's margin profile in the next 2-3 quarters.
- Focused on enhancing insurer relationships and expanding benefits in the retail segment.
- Cashless facility being expanded to non-network hospitals for emergency access.
- Strong emphasis on technology for service delivery and customer retention.
Challenges and Opportunities:
- Opportunities seen in expanding the retail market share and leveraging technology for growth.
- Optimistic outlook expressed by the management regarding future prospects and growth potential.
