Update February 2020: Meso is now being operated as an open-source project. Learn more at https://meso.health.

We’re excited to announce that we’re expanding Watsi to provide health coverage! Together, Watsi Crowdfunding and Watsi Coverage (Meso) will help create a world where everyone has access to care — whether that’s by raising money through crowdfunding or enrolling in health coverage.

Five years ago, in a Costa Rican town called Watsi, one of our founders met a woman on a hot, crowded bus who was asking passengers for donations to fund her son's healthcare.

Inspired by that woman, we created Watsi to help people access healthcare. We started by launching our crowdfunding platform, which has processed more than $9M from 23,154 donors and funded healthcare for 13,772 patients.

Ten-year-old Witcheldo before surgery.

One of those patients is Witcheldo from Haiti. Watsi donors contributed $1,500 to the cost of open-heart surgery to treat a life-threatening cardiac condition—a condition he developed due to a case of untreated strep throat.

If Witcheldo had access to health coverage, his strep throat could have been treated with an antibiotic for a few dollars. Cases like his inspired us to explore different models of providing health coverage, including community-based health insurance.

Witcheldo after life-saving heart surgery.

In the countries where we work, universal health coverage is a top priority, but it’s prohibitively expensive because up to 40% of healthcare funding is lost to inefficiencies. These inefficiencies stem from administering complex systems with pen and paper, which drives up costs and results in errors, fraud, and a lack of insight into the quality of care.

We met one government insurance administrator who couldn’t verify whether the claims she received were for patients enrolled in the insurance program, because doing so would require manually digging through thousands of enrollment records – so she approved every claim. As a result, the system was teetering on bankruptcy, requiring the government to increase premiums, and forcing members to drop out.

We believe low-income countries have an opportunity to leapfrog the inefficiencies of traditional health coverage by building their national programs with technology. Recognizing this opportunity, YC Research gave us funding to build technology that makes it easy to administer health coverage.

With their support, a few of us moved to rural Uganda and spent three months living in a convent alongside the nuns who own and operate the local clinic. We developed our system with direct input from the community, local stakeholders, and global experts.

In six weeks, we coded a mobile app to run the system and opened enrollment in March 2017. To date, 98% of the community has signed up, bringing the program’s membership to 5,880 people. Once enrolled, members can access care at the clinic. Our app streamlines enrolling members, verifying their identity with their thumbprint when they visit the clinic, collecting data on the care they receive, and reimbursing the provider for their costs.

The primary benefit of automating health coverage from end-to-end is improved efficiency. For example, our mobile app has reduced the time it takes to enroll new members and process claims from weeks to minutes. And by surfacing real-time data, we have insight into the cost and quality of care, making it possible to do things like identify unnecessary prescriptions and ensure treatment guidelines are followed. Currently, the cost of care is just $0.78 per member per month.

193 of the world's governments share a goal to achieve universal health coverage by 2030. If we prove our system can make health coverage more affordable, we believe governments will adopt our technology to accelerate progress towards universal health coverage. But most importantly, when we think back to that woman on the bus, we’re excited to be one step closer to ensuring she never has to worry about affording the care her son needs to get healthy.

We hope you’ll support our journey towards making healthcare a reality for everyone by donating to a Watsi patient.