波士顿咨询：2025重建信任：印度健康保险体系中的欺诈、浪费与滥用行为治理研究报告（英文版）（48页）.pdf

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1、REBUILDING TRUSTREBUILDING TRUSTCombating Fraud,Waste,and Abuse in Indias Health Insurance EcosystemNovember 2025ForewordIndias health insurance ecosystem stands at the cross-roads of extraordinary promise and pressing responsibility.The sectors rapid transformationfueled by digital innovation,expan

2、ded coverage,and publicprivate collaborationhas laid the foundation for equitable access to care.Yet,as the system scales,the silent and systemic challenge of fraud,waste,and abuse(FWA)threatens to erode the very trust and financial resilience it seeks to build.This report,“Rebuilding Trust-Combatin

3、g Fraud,Waste,and Abuse in Indias Health Insurance Ecosystem”,is a call to action for leaders across insurers(including TPAs acting on their behalf),providers,corporates and government/regulator to collectively safeguard the integrity of Indias healthcare promise.The findings in this report go beyon

4、d diagnosisthey outline a national roadmap for integrity.Anchored in data,technology,and shared accountability,the framework proposed advocates for a transition from reactive oversight to proactive prevention.It urges us to see connected care,interoperability,and generative AI not as distant innovat

5、ions,but as present tools to build transparency and efficiency at scale.By embedding trust,standardization,and deterrence into the fabric of our health-financing system,India can set a global benchmark for equitable and sustainable healthcare/health insurance governance.Ultimately,this is not merely

6、 about curbing inefficiencyit is about restoring faith,about rebuilding trust.Every rupee saved from fraud strengthens the nations capacity to extend protection to another family;every act of accountability brings us closer to the vision of“Insurance for All by 2047.”The journey from suspicion to so