MANILA, Philippines – When you’re feeling ill, the last thing you probably want to do is have to navigate the technicalities of your health insurance plan to learn how you can get the care you need. Because for many of us, health insurance can be tough to understand, with its intricate computations and its use of complicated terminologies. 

That’s one of the main problems that health insurance startup Hive Health looks to address as part of its mission to make healthcare more accessible in the Philippines. 

Born from the challenges brought about by the COVID-19 pandemic, Hive Health’s founders, Camille Ang and Jiawen Tang were motivated to address the gaps in healthcare accessibility and affordability in the country, naming breadth of coverage and complexity of processes as pain points.

Ang, who grew up in the Philippines, explained at a media event on Tuesday, November 14 that over one and a half million Filipinos are forced into poverty every year due to health shocks, and less than 10% of the population have access to health plans beyond PhilHealth. 

“For those that are lucky to have an employer-sponsored health plan, the average out-of-pocket spend is at 56%, and Filipinos find it quite difficult to use one’s health plan,” she added. 

The startup’s solution is to leverage tech and data to make quality healthcare more affordable and easier to use, especially for the small-medium enterprise (SME) segment, explained Tang, who grew up in China.  

Hive Health is a fully licensed digital health insurer that offers comprehensive health maintenance organization (HMO) plans that encompass outpatient, inpatient, emergency and dental care through a network of over 1,700 hospitals and clinics, and over 60,000 doctors across the country. 

For those unfamiliar, HMO is a type of health insurance plan that provides coverage and care through a network of doctors and service providers. 

What sets Hive Health apart from other HMO insurers, the company says, is that it leverages data-driven innovations to streamline the insurance customer experience, leading to faster processing of requests, and easier consolidation of medical records. 

The startup has an app, where users can manage oneself and one’s dependents’ care, including tasks like requesting letters of approval (LOA), viewing your plan’s benefits, finding nearby providers, booking a consultation, scheduling annual physical exams, and viewing your medical records, and it’s accessible from your smartphone or computer. 

All-in-one digital platform

By bringing all these tasks on a digital platform, Hive Health is able to centralize patient data and easily access them for its back-office operation needs. That then allows it to simplify and speed up important processes like policy administration and claims processing. 

Requesting an LOA on Hive Health, for example, only takes minutes, whereas the traditional process could take a couple of days with insurers that don’t have a digital platform.

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Tang said they’re able to reduce the time it takes to issue these documents because patients book their doctor consultations and tests on the same app where they place the request. That saves the startup from a lot of manual administrative work that’s involved with approving insurance usage. 

“We’re also proud of our one-of-a-kind vertically integrated telehealth and care coordination model that bridges virtual and in-person care,” said Tang. 

“Patients can book on-demand video teleconsultations with our team of Hive doctors, who use our in-house electronic medical records system to enable patients to get more accurate diagnoses and access the right care whenever they need it.” 

Hive Health also offers mental health consultations, medicine coverage, preventive care, and maternity reimbursements, on top of the aforementioned benefits. 

Additionally, business owners and human resource managers can use the app’s HR dashboard to simplify the onboarding and offboarding of employee beneficiaries, which promotes engagement wellness. 

Harvard roots

Hive Health was founded at Harvard and Stanford while Ang and Tang were pursuing their dual MBA and MPA in International Development degrees at those two universities.

It won the grand prize at the Harvard New Venture Competition in 2021, the same annual competition that propelled ride-sharing app Grab in 2011 where it won second prize, helping it secure support later from venture capital firms like YCombinator and Gentree Fund. 

During the recently concluded media event, Hive Health also announced it was acquiring Health Plan Philippines, Inc. (HPPI), one of the pioneering HMO service providers in the country.

The initiative, the company says, will allow Hive Health to integrate HPPI’s nationwide provider network and institutional knowledge to improve patient experience across virtual and in-person care. It also allows Hive Health to share its technology and data-driven innovations to the HPPI’s existing members. 

“Hive Health has been a valued partner of HPPI given our shared missions,” said Natasha Reyes, CEO of HPPI. “I have seen how the team is able to deliver changes to improve the patient experience much faster than I would have expected, and how they genuinely care about making healthcare accessible to more Filipinos.” – Rappler.com