Mr Anil Swarup Dir General, Ministry of Labour & Development, Govt of India presented on the biggest health insurance scheme (RSBY) run by the government at a seminar hosted by CIRM in Chennai, India
7. HEALTH INSURANCE COVERAGE VERY LOW OOP = 83% of total health spending in India Data for All- India 2004
8. OUT OF POCKET (OOP) EXPENSES AND INDEBTEDNESS IN INDIA (Amount in $US) ALL INDIA POOREST 1. Average OOP Payments made per hospitalization in Govt. facilities 70 54 2. Average OOP Payments made per hospitalization in private facilities 158 115 3. %age of people indebted due to OP Care 23 21 4. %age of people indebted due to IP Care 52 64 SOURCE: NSSO, GOI
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14. Insurance Company State Nodal Agency Health Care Providers 7. Enrollment of Beneficiaries FKO 7. Verification of Smart Card Government of India BPL Data www.rsby.in 5. Empanelment District Kiosk DKM Call Centre 5. Setting-up Setting-up 1. Prepare in given format 2. Send for verification 3. Upload on website after verification 4. Selection through tendering 6. Issuance of FKO Card 8. Download of FKO Data at DKM server 9. Submission of data and bill 10. Payment to Insurer 11. Utilisation of Services 12. Claim Process Awareness Health Camps BPL Beneficiaries
28. Current Status of Implementation of RSBY …. since its roll out from 1.4.08 Category Numbers Number of People Covered 75 million Number of people benefitted 700,000 Number of States Started the Process 26 Number of States Distributing Smart Cards 22 Number of States where Policy has Started 22 Number of Insurance Companies involved 11 Number of Smart Cards Distributed 18.5 million
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30. Note: Estimate based on monthly hospitalizations; includes multiple procedures within same household in case of RSBY
31. Note: 78 districts are sorted by male utilization rate (blue line). If female utilization rate (red dot) is higher than male one, then red dot is above blue line.
32. Note: Estimates are based on ALL districts with RSBY program, both completed and in progress
37. Beneficiary Response to the Treatment Provided in the Hospitals SOURCE: Evaluation Survey in Kerala by The Research Institute, Rajagiri College of Social Sciences
38. Beneficiary Response to the Overall Experience at the Hospitals SOURCE: Evaluation Survey in Kerala by The Research Institute, Rajagiri College of Social Sciences
39. Service Delivery – Health Status Post RSBY Treatment Source: Survey conducted by The Research Institute Rajagiri College of Social Sciences 2009 Health Status Percent Has improved completely 89.8 No improvement 0.9 Partially improved 9.3 Total 100.0