iPMI Global Speaks with Sumit Gaurav, CEO, Roy Medical Assistance

In this exclusive iPMI Global interview, Christopher Knight, CEO, iPMI Global, met with Sumit Gaurav, CEO, Roy Medical Assistance. They discussed 2023 in detail and looked at the achievements of Roy Medical Assistance in the international medical assistance market, over the past year.

Please introduce yourself and background in the international medical assistance market:

Sumit Gaurav, Chief Executive Officer of Roy Medical Assistance. We are a Healthcare Risk Management company which offers a comprehensive spectrum of fully integrated assistance, medical case management and cost containment services. We serve a multitude of insurance, assistance, air ambulance, and corporate clients, located in more than 65 countries around the world.

Roy Medical Assistance was founded in 2016 and is a privately held, independent organization. We are located in Gurguan, India.

Over the years, the range of services we’re able to offer our clients has truly evolved with solutions for the following industry segments: business and leisure travel, expats, student iPMI, long-term retirees, destination and major medical and domestic health markets. This growth in our service spectrum is driven as much by client demand as it is through our own vision of what we believe the market needs.

In the past 12 months, what has your business achieved in the international assistance market?

In the past 12 months, RMA has achieved significant growth in all sectors. We have continued to focus on maintaining our relationships with our partners. Behind the scenes we constantly meet with our provider network to improve quality of care, and costs – this has helped a great amount.

We have also expanded our Preferred Provider Network in Singapore, Maldives, Hong Kong, and South Korea, where we are present and active. We have given more options to our clients with more hospitals, clinics and doctors, where our clients can get easy healthcare access in any cities, islands, deserts and mountains, with access to affordable cost and excellent patient care services. Our initial project has been focused on the increasing options in popular tourist destination like Indonesia, Thailand, China, South Korea, India, Nepal, Singapore, Vietnam, Maldives, UAE etc.

We commenced services in the Philippines and South Korea in 2022-2023. In both countries we have developed 100 + PPN. During the time, clients have been requesting tele consultations, so we have set up a 24/7/365 telemedicine service.

Additionally, we have focussed on extending our Tele consultation solutions to multiple countries with highly qualified medical professionals to provide real time communications with patients.

How did you do it?

We worked really hard for the last 7 years with all services providers globally. Year by year all service providers evaluate our work profile, payments terms and at the same time we did our best to satisfy our clients with our services, including cost containment. After all evaluation, Service providers management agree to accept our terms and conditions, which helped us to meet our task. With the result, RMA is a growing global brand in the IPMI sector. They know RMA can tackle risk management and provide the best solutions locally, and globally.

Geographically speaking, where are the “hot” international medical assistance markets currently?

In terms of the international medical assistance “hot” markets, these could be interpreted in terms of high medical cost and travel safety concerns. RMA is mainly working in Asia and some parts of the Middle East. We are experienced in this region. A good example is Singapore and China. Due to the lack of healthcare cost regulations, medical treatment costs in the hospitals are exorbitant. In both countries we are working directly with our PPN, to lower costs and increase the standard of care.

Looking at 2024, what do you have planned for the international medical assistance market?

This is good questions Chris. With 2024 knocking at the door, we will work to increase the service providers, doctors and professional healthcare facilitators. At the same time, we will have many options to verify cost containment and provide better solutions to our clients. During this year we will start our services directly in 1-2 new countries with a focus on cost containment.

Since Covid-19, how has the international medical assistance market changed?

Yes, since COVID 19, the healthcare industry has changed drastically. The healthcare industry is seeing an increase in patients and medical attention. Since covid 19, everyone is fearful about their health, and they are going to health checkups more regularly. During this time as we are seeing many changes in the healthcare Industry.

  • People are more aware about Health insurance and travel Insurance. As we are seeing some countries passed the regulation where people must have health insurance, with COVID 19 cover.
  • Since COVID 19 travellers don’t wish to visit the Hospital for unnecessary reasons, so they demand teleconsultation.
  • Since COVID 19, hospitals have increased their prices.
  • Increase the adoption of digital health solutions, including health apps and wearable devices. This technology plays a role in supporting remote patient monitoring, personalized healthcare and preventive measures.

What role is artificial intelligence and machine learning playing in the international medical assistance market?

Artificial intelligence (AI) and machine learning (ML) are playing increasingly important roles in the international medical assistance market. These technologies offer various applications and benefits that contribute to more efficient and cost-effective healthcare management.

Here are some ways AI and ML are involved:

Fraud Detection and Prevention:

AI and ML algorithms can analyse vast amounts of healthcare data to identify patterns indicative of fraudulent activities, such as billing irregularities or unnecessary procedures. This helps insurance companies and healthcare providers combat fraud and reduce costs.

Claims Processing:

Automation through AI and ML in claims processing can streamline and accelerate the assessment of insurance claims. This leads to quicker reimbursement for healthcare providers and reduces administrative costs for insurance companies.

Predictive Analytics for Cost Management:

Predictive analytics powered by machine learning can help healthcare organizations anticipate patient needs, identify high-risk individuals, and predict potential healthcare costs. This allows for proactive interventions to manage costs and improve patient outcomes.

Utilization Management:    

AI can assist in optimizing resource allocation and utilization in healthcare settings. By analysing historical data, machine learning algorithms can provide insights into the most effective and cost-efficient utilization of medical services and resources.

When we look at the global international medical assistance market, where do you see the major opportunities?

A lot of major opportunities exist in the global international medical assistance market, driven by advancements in technology, changing healthcare landscapes, and the increasing need for cost-effective healthcare solutions. Here are some key areas where significant opportunities may be present:

  1. AI and Machine Learning Solutions: Opportunities lie in the development and implementation of advanced AI and machine learning solutions for fraud detection, claims processing, predictive analytics, and decision support. Innovations in these areas can lead to more efficient and cost-effective healthcare management.
  2. Telehealth and Remote Patient Monitoring: With the growing acceptance of telehealth services and the need for remote patient monitoring, there are opportunities for companies offering solutions in these areas. This includes technologies that facilitate virtual consultations, remote health monitoring devices, and platforms for data analytics.
  3. Value-Based Care Solutions: As healthcare systems transition towards value-based care models, there are opportunities for companies offering solutions that focus on improving patient outcomes while managing costs. This includes tools for performance analytics, care coordination, and quality measurement.
  4. Supply Chain Optimization: Companies that offer solutions for optimizing the healthcare supply chain, including inventory management, demand forecasting, and procurement efficiency, can contribute to cost containment efforts.
  5. Global Health Insurance and Assistance Services: With the increasing globalization of healthcare, opportunities exist for companies providing international health insurance and assistance services. This includes services related to medical evacuations, travel insurance, and healthcare access for expatriates.

What is the scope for global international medical assistance market?

The scope for the global international medical assistance market is dynamic and influenced by ongoing developments in healthcare policies, technology, and market trends. Companies that can adapt to these changes, provide innovative solutions, and address the evolving needs of the healthcare industry are well-positioned to thrive in this market. Here are key aspects contributing to the scope and growth of this market:

  1. Rising Healthcare Costs: The escalating costs of healthcare services, procedures, and medications globally create a strong demand for effective cost containment solutions. As healthcare expenditures continue to rise, there is an increasing focus on strategies and technologies that can help manage and reduce these costs.
  2. Technological Advancements: Advances in technology, particularly in artificial intelligence (AI), machine learning (ML), blockchain, and data analytics, provide innovative tools for optimizing healthcare processes, reducing inefficiencies, and combating fraud. These technologies play a crucial role in enhancing the scope of medical cost containment solutions.
  3. Globalization of Healthcare: The globalization of healthcare, driven by increased medical tourism, international patient transfers, and the mobility of expatriates, expands the market for cost containment services on a global scale. Companies that offer solutions for managing healthcare costs across borders have significant opportunities.
  4. Increased Focus on Preventive Care: There is a growing emphasis on preventive care and wellness programs to reduce the overall burden of healthcare costs. Companies offering solutions that promote preventive measures and early interventions contribute to the cost containment landscape.
  5. Collaboration and Partnerships: Collaboration between healthcare providers, payers, technology companies, and service providers is becoming more common. Strategic partnerships can enhance the scope of cost containment efforts by leveraging combined expertise and resources.
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