India

Year Joined: 2010 Membership: Full Member

Reaching the informal sector.

In 2007, the state of Andhra Pradesh launched the Aarogyasri health insurance scheme, gradually extending coverage for catastrophic, inpatient care to the entire population below the poverty line (BPL) statewide. One year later at the national level, the Ministry of Labour and Employment launched RSBY to provide health insurance benefits to BPL populations.

Summary of UHC Journey

In 2007, the state of Andhra Pradesh launched the Aarogyasri health insurance scheme, gradually extending coverage for catastrophic, inpatient care to the entire below-poverty-line (BPL) population statewide. One year later at the national level, the Ministry of Labour and Employment (MoLE) launched the Rashtriya Swasthya Bima Yojana (RSBY) program to provide health insurance benefits to BPL populations. RSBY is being implemented by state governments in 23 different states, with plans to cover the entire BPL population in India.

Both programs are entirely cashless, with no required co-payments at the point-of-service. Aarogyasri requires no member contribution whatsoever, while RSBY has made the decision to charge beneficiaries a small registration fee.RSBY is financed through a mix of central and state government revenues, while Aarogyasri is financed entirely at the state level with no support of the central government.

Both programs have also made use of commercial insurers for administrative functions.In both cases, the selected insurer is paid a defined premium from the government per beneficiary, and carries the actuarial risk of program beyond that point.

The RSBY program is unique in its involvement of local NGOs in the process of building awareness, and identifying and enrolling targeted beneficiaries. RSBY also issues one SmartCard per family at the time of enrollment. SmartCards aid enrollment and claims processing, and information on all enrolled family members is stored on the card.

Activity as a JLN Member

India is one of the founding members of JLN. Members of the Indian delegation contributed to the following knowledge products:

  • Primary Health Care (PHC) Measurement for Improvement Indicator Inventory
  • Engaging the Private Sector in PHC to Achieve UHC: Advice from Implementers to Implementers
  • UHC Primary Health Care Self-Assessment Tool
  • UHC Primary Health Care Self-Assessment: Summary Report from Four Country Pilots
  • Open Health Data Dictionary
  • Software Comparison Tool
  • Connecting Health Information Systems for Better Health
  • Determining Common Requirements for National Health Insurance Information Systems
  • Toolkit for Medical Audit Systems: Practical Advice from Implementers to Implementers
  • Costing of Health Services for Provider Payment: A Practical Manual
  • Costing Manual: Online Course
  • Costing Manual: Tools & Templates,Financing and Payment Models for Primary Health Care: Six Lessons from JLN Country Experience
  • Compendium: 12 country approaches to covering poor and informal populations to achieve UHC
  • Primary Health Care Measurement for Improvement Toolkit
  • Governing to Improve Quality Toolkit
  • India Chhattisgarh State: Approaches to covering poor, vulnerable, and informal populations to achieve UHC
  • India Andhra Pradesh: Approaches to covering poor, vulnerable, and informal populations to achieve UHC
  • 24/7 Call Center and End-to-end IT solution
  • JLN Population Coverage Technical Initiative Workshop Summary
  • International Lessons for RAMED

In 2018, representatives from Ghana participated in the Leveraging Resources for Efficiency, Fiscal Policy for Public Health, PHC Financing and Payment, and Domestic Resource Mobilization collaboratives.

Applying JLN Knowledge

RSBY and Aarogyasri hosted a delegation from Ghana in 2011 to exchange knowledge on India’s experience with ICT, claims processing, biometric membership ID’s, and subscriber authentication at the provider site.

Ghana’s National Health Insurance Authority received follow-up support from Arogyasri to establish a call center and RSBY on biometric ID’s. Ghana established their call center in early 2012 and began rolling out biometric ID cards in early 2014.

Resource widget

Scaling up National Health Insurance in Nigeria

Expanding access to health insurance is an important part of an overall strategy to achieve universal health coverage (UHC). Nigeria will need to make crucial decisions if access and financial protection in the context of health are to be expanded to cover the majority of the population. The Health Policy

9236 downloads

The Impact of Universal Coverage Schemes in the Developing World

The review indicates that UHC interventions in low- and middle-income countries improve access to health care. It also shows, though less convincingly, that UHC often has a positive effect on financial protection, and that, in some cases it seems to have a positive impact on health status. The review also

1847 downloads

Impact of Health Insurance Schemes for the Informal Sector in LMIC’s

This paper summarizes the literature on the impact of state subsidized or social health insurance schemes that have been offered, mostly on a voluntary basis, to the informal sector in low- and middle-income countries. A substantial number of papers provide estimations of average treatment on the treated effect for insured

2714 downloads

Country Core Group Representatives

Alok Saxena

Ministry of Health and Family Welfare, India

Vinod Varma

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