Consultant- Hospital, Enrollment, M&E and Computer programmer
Accounts Manager and other support Staff.
District RSBY Consultant ( in position 16/18 districts)
Chief Medical and Health Officers are DKM and a separate Nodal officer has been nominated for each district.
The Hospital Administrator at District Hospital and Block programme Manager under NRHM will coordinate Hospital activities
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
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
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
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
District-wise Enrolment of Beneficiaries 28th June 2011 RSBY RRM Ranchi 6
District-wise Enrolment of Beneficiaries 28th June 2011 RSBY RRM Ranchi 7
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
Enrolment of Beneficiaries 28th June 2011 RSBY RRM Ranchi 9
Empanelment of Hospitals 28th June 2011 RSBY RRM Ranchi 10
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
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
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
28th June 2011 RSBY RRM Ranchi 14
Any Issue with the Fund flow at different levels
Flow from State Government- No
Flow from Central Government- Delayed receipts.
Flow from IA to TPA- No.
Flow from TPA to Hospitals- ?
Submission of Audited Financial Statements to the Government of India- Done 28th June 2011 RSBY RRM Ranchi 15
Utilization of Services and Claims 28th June 2011 RSBY RRM Ranchi 16
Utilization of Services and Claims 28th June 2011 RSBY RRM Ranchi 17
Utilization of Services and Claims 28th June 2011 RSBY RRM Ranchi 18
Utilization of Services and claims 28th June 2011 RSBY RRM Ranchi 19
Fraud /Abuse Control 28th June 2011 RSBY RRM Ranchi 21
De-Empanelment of Hospitals – 28th June 2011 RSBY RRM Ranchi 22
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
Evaluation 28th June 2011 RSBY RRM Ranchi 24
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
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
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