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For bhopal meeting july 2011


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PPT for meeting with IA . Prelude to roll out of RSBY in Madhya Pradesh

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For bhopal meeting july 2011

  1. 1. RashtriyaSwasthya Bima Yojna in the State of Chhattisgarh<br />28th June 2011<br /> RSBY RRM Ranchi <br />1<br />
  2. 2. IMPLEMENTATION OF THE SCHEME<br />Setting up of Nodal agency<br />Identification of Insurance agency<br />Appointment of DKM and FKOs<br />BPL data base<br />Enrollment of Beneficiaries and Delivery of Smart Card to commence<br />Empanelment of Government and private institutions<br />Payment of insurance premium to the insurance service provider.<br />Delivery of health services<br />
  3. 3. State Nodal Agency-Chhattisgarh<br />Department of Health and Family Welfare – Nodal Department <br /><ul><li>A Separate Nodal Agency under State Health Society has been constituted.</li></ul>Nodal Agency comprise of <br /><ul><li>Director Health Services as Ex- officio CEO
  4. 4. Additional CEO -functional or Executive CEO
  5. 5. Consultant- Hospital, Enrollment, M&E and Computer programmer
  6. 6. Accounts Manager and other support Staff.
  7. 7. District RSBY Consultant ( in position 16/18 districts)
  8. 8. Chief Medical and Health Officers are DKM and a separate Nodal officer has been nominated for each district.
  9. 9. The Hospital Administrator at District Hospital and Block programme Manager under NRHM will coordinate Hospital activities
  10. 10. Health Workers ( male and Female ) have been designated as FKO in Rural areas whereas AWW work as FKO in Urban areas</li></ul>28th June 2011<br /> RSBY RRM Ranchi <br />3<br />
  11. 11. Preparation of BPL Data<br />28th June 2011<br /> RSBY RRM Ranchi <br />4<br />
  12. 12. Enrollment activities:<br />Ensuring relevant keys ( cards)-DKMA and FKO are available<br />District level sensitization workshops.<br />Ensuring FKOs<br />Microplaning for enrollment activities with the help of district authorities.<br />Close monitoring<br />Reasons for non enrollment<br />Poor logistics and commitment of enrollment team.<br />Capacity of the enrollment team.<br />Target oriented approach of TPA/ Smart card vendor ( Business Guarantee).<br />Migration of the beneficiary/Death of the beneficiary.<br />28th June 2011<br /> RSBY RRM Ranchi <br />5<br />
  13. 13. Enrolment of Beneficiaries( activities)<br />28th June 2011<br /> RSBY RRM Ranchi <br />6<br />
  14. 14. Empanelment of Hospitals<br />District Workshops for hospitals organized at all the Places<br />District administration actively involved in the empanelment process- A three member committee constituted for recommending and delisting of hospitals<br />Except few districts, Private hospitals are available across the state.<br />Presently No special IEC or BCC activities are done by Insurer<br />Innovation in empanelment process<br />EOI for empanelment issued by Nodal agency<br /> Display board at Empanelled hospital with Govt Logo and DHS <br />Facilitation with Govt communication regarding empanelment of all government accredited hospitals in the scheme.<br />Main issues and learning from Empanelment process.<br />The District Administration should take lead.<br />Insurance companies should reciprocate <br />The MOU should be shared with nodal agency<br />28th June 2011<br /> RSBY RRM Ranchi <br />7<br />
  15. 15. Fund flow at different levels<br /><ul><li> Flow from State Government- No
  16. 16. Flow from Central Government-
  17. 17. Flow from IA to TPA- No.
  18. 18. Flow from TPA to Hospitals- ?</li></ul>28th June 2011<br /> RSBY RRM Ranchi <br />8<br />
  19. 19. 28th June 2011<br /> RSBY RRM Ranchi <br />9<br />
  20. 20. 28th June 2011<br /> RSBY RRM Ranchi <br />10<br />
  21. 21. 28th June 2011<br /> RSBY RRM Ranchi <br />11<br />
  22. 22. Thank You<br />28th June 2011<br /> RSBY RRM Ranchi <br />12<br />