RSBY regional review meeting eastern region Ranchi 28th June 2011
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RSBY regional review meeting eastern region Ranchi 28th June 2011

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RSBY review meeting for eastern region held at Ranchi on 28th June 2011

RSBY review meeting for eastern region held at Ranchi on 28th June 2011

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RSBY regional review meeting eastern region Ranchi 28th June 2011 Presentation Transcript

  • 1. Rashtriya Swasthya Bima Yojna in the State of Chhattisgarh
    28th June 2011
    RSBY RRM Ranchi
    1
  • 2. State Nodal Agency-Chhattisgarh
    Department of Health and Family Welfare – Nodal Department
    • A Separate Nodal Agency under State Health Society has been constituted.
    Nodal Agency comprise of
    • Director Health Services as Ex- officio CEO
    • 3. Additional CEO -functional or Executive CEO
    • 4. Consultant- Hospital, Enrollment, M&E and Computer programmer
    • 5. Accounts Manager and other support Staff.
    • 6. District RSBY Consultant ( in position 16/18 districts)
    • 7. Chief Medical and Health Officers are DKM and a separate Nodal officer has been nominated for each district.
    • 8. The Hospital Administrator at District Hospital and Block programme Manager under NRHM will coordinate Hospital activities
    • 9. Health Workers ( male and Female ) have been designated as FKO in Rural areas whereas AWW work as FKO in Urban areas
    28th June 2011
    RSBY RRM Ranchi
    2
  • 10. Audit
    External auditors have been appointed.
    Audit for 2009-10 completed. AG CG carried Survey Audit
    Audit for 2010-11 under process.
    State Server
    Being procured and will be set up at NIC Raipur.
    Personnel recruited and in position
    Presently enrolled data is stored on External hard disks.
    28th June 2011
    RSBY RRM Ranchi
    3
  • 11. Observations on RSBY website
    The web site needs to be updated there are 18 districts.
    The figures needs to be updated on regular basis. Date of update should be mentioned.
    List of delisted hospitals to be displayed prominently.
    Links to other RSBY sites needs to be included.
    Sitemap
    The SW downloads versions inside the state login and on main page differs.
    28th June 2011
    RSBY RRM Ranchi
    4
  • 12. Preparatory Work for Renewal Districts
    Status of Availability of Renewal Software with the Insurance Company (if already selected)
    28th June 2011
    RSBY RRM Ranchi
    5
  • 13. District-wise Enrolment of Beneficiaries
    28th June 2011
    RSBY RRM Ranchi
    6
  • 14. District-wise Enrolment of Beneficiaries
    28th June 2011
    RSBY RRM Ranchi
    7
  • 15. What were the main reasons for non-enrollment of beneficiaries?
    Poor logistics and commitment of enrollment team.
    Capacity of the enrollment team.
    Target oriented approach of TPA/ Smart card vendor ( Business Guarantee).
    Migration of the beneficiary/Death of the beneficiary.
    Is data of missing families in the BPL list being collected in prescribed format at enrollment station?
    No.
    28th June 2011
    RSBY RRM Ranchi
    8
  • 16. Enrolment of Beneficiaries
    28th June 2011
    RSBY RRM Ranchi
    9
  • 17. Empanelment of Hospitals
    28th June 2011
    RSBY RRM Ranchi
    10
  • 18. Empanelment of Hospitals
    District Workshops for hospitals organized at all the Places
    District administration actively involved in the empanelment process- A three member committee constituted for recommending and delisting of hospitals
    Except few districts, Private hospitals are available across the state.
    Presently No special IEC or BCC activities are done by Insurer
    Innovation in empanelment process?
    Yes EOI for empanelment issued by Nodal agency
    Display board at Empanelled hospital with Govt Logo and DHS
    Govt communication regarding empanelment of all government accredited hospitals in the scheme.
    Main issues and learning from Empanelment process.
    The District Administration should take lead.
    Insurance companies should reciprocate
    The MOU should be shared with nodal agency
    28th June 2011
    RSBY RRM Ranchi
    11
  • 19. Have Insurance Companies done mapping of Empanelled Hospitals on the district map for each district? Show this mapping on the slide.
    No, SNA is doing it .
    28th June 2011
    RSBY RRM Ranchi
    12
  • 20. Data Analysis
    Show some data analysis based on
    Conversion ratio
    Hospitalization ratio Average and Gender wise
    Average Family size
    Burnout Ratio
    RSBY Summary 22nd June 2011.xlsx
    Disease pattern
    28th June 2011
    RSBY RRM Ranchi
    13
  • 21. 28th June 2011
    RSBY RRM Ranchi
    14
  • 22. Any Issue with the Fund flow at different levels
    • Flow from State Government- No
    • 23. Flow from Central Government- Delayed receipts.
    • 24. Flow from IA to TPA- No.
    • 25. Flow from TPA to Hospitals- ?
    Submission of Audited Financial Statements to the Government of India- Done
    28th June 2011
    RSBY RRM Ranchi
    15
  • 26. Utilization of Services and Claims
    28th June 2011
    RSBY RRM Ranchi
    16
  • 27. Utilization of Services and Claims
    28th June 2011
    RSBY RRM Ranchi
    17
  • 28. Utilization of Services and Claims
    28th June 2011
    RSBY RRM Ranchi
    18
  • 29. Utilization of Services and claims
    28th June 2011
    RSBY RRM Ranchi
    19
  • 30. Grievance Redressal Mechanism
    28th June 2011
    RSBY RRM Ranchi
    20
  • 31. Fraud /Abuse Control
    28th June 2011
    RSBY RRM Ranchi
    21
  • 32. De-Empanelment of Hospitals

    28th June 2011
    RSBY RRM Ranchi
    22
  • 33. IEC Activities
    Funds have been released to all the districts for holding health camps/ Melas for increasing utilization of services.
    TV spots developed and broadcasted.
    Radio jingles developed in local language and dialect and broadcasted
    Distribution of printed pamphlets and material.
    Regular meeting cum review cum reconciliation workshops being held for hospitals
    RSBY material is included in 14th round Mitanin training programme ( ASHA)
    RSBY is part of Fast track training programme for District Health planning under NRHM.
    Review meetings are being organized regularly on a monthly basis for District Collectors, CMHOs, DPMs and Civil Surgeons besides video conferencing on fixed monthly dates.
    Media workshops.
    28th June 2011
    RSBY RRM Ranchi
    23
  • 34. Evaluation
    28th June 2011
    RSBY RRM Ranchi
    24
  • 35. Evaluation Study
    Has any formal study being planned/ conducted by the State Government?
    Quality of providers in RSBY – Facility Survey- ongoing
    Pre and Post Hospitalization Survey of beneficiaries
    Study has been undertaken by PHRN report available on PHRN website.
    Evaluation study –RFP will be floated shortly.
    28th June 2011
    RSBY RRM Ranchi
    25
  • 36. Decisions taken/ proposed
    Incentives have been provided to Providers of Public Hospitals
    Training of Jeevan Deep Samittees is under process as part of quality development initiative
    CM hospital development has been set up for Gap support to hospitals in difficult areas
    Scheme extended to
    Building and construction worker
    PTG not covered
    Families affected by Naxallite violence
    Mitanin ( ASHA)
    NRHM contractual staff
    Web portal and Centralized help line started
    List of packages increased to 1130 .
    28th June 2011
    RSBY RRM Ranchi
    26
  • 37. Suggestions for Improvement
    Capacity building at all levels
    Real time data management
    Online transaction of claims and settlement.
    Trust and Transparency among the team.
    28th June 2011
    RSBY RRM Ranchi
    27
  • 38. Thank You
    28th June 2011
    RSBY RRM Ranchi
    28