MILK Brief #24: Doing the Math - Health Insurance and Chronic Disease in Nigeria

In this MILK brief, the MicroInsurance Centre’s MILK Project Client Math team partnered with Hygeia Community Health Care (a collaborative effort among the PharmAccess Foundation, the Health Insurance Fund, and the Nigerian HMO and hospital network, Hygeia Nigeria Limited) to analyze the value of its product for clients with chronic disease, specifically hypertension. HCHC seeks to facilitate better health outcomes for low-income families in Lagos by reducing health care costs and improving the quality of care.

We found that HCHC clients use preventative hypertension services more frequently and consistently than uninsured respondents and have made more lifestyle changes than the uninsured comparison group, suggesting that the insurance has reduced barriers to access and played a role in facilitating healthy behavior change. To compound this benefit, HCHC clients also face dramatically lower costs of treatment and services, though their opportunity cost of seeking care remains the same as it does for uninsured clients. At the same time, we find that the lifestyle changes that insured clients have undertaken, specifically dietary changes, have resulted in new and unforeseen nonmedical costs for this group. This sheds light on the consideration that in some cases, by virtue of their more frequent contact with the health system, insured individuals actually spend more on their health than do uninsured individuals. These expenses are important to quantify as they can lead to improved health outcomes but can also discourage short-term usage of health services.