Rashtriya Swasthya Bima Yojna in the         State of Chhattisgarh28th June 2011   RSBY RRM Ranchi        1
Main features•   Business Model for all Stakeholders•   Empowering the beneficiary•   Insurers•   Hospitals•   Government•...
IMPLEMENTATION OF THE SCHEME– Setting up of Nodal agency– Identification of Insurance agency– Appointment of DKM and FKOs–...
State Nodal Agency-Chhattisgarh      Department of Health and Family Welfare – Nodal Department           A Separate Noda...
www.rsby.in                                                        4. Selection through tenderingGovernment               ...
Status of scheme•   No of districts covered:- 18•   Total BPL families enrolled till date:- 15,48,696•   Total population ...
Moral hazards/ issues• At the time of enrollment• At the time of empanelment• For utilization of services
Going Beyond BPL• RSBY is being extended to other categories of  Unorganized sector workers who are non-BPL     •   NREGA ...
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Rsby for consultants review cum training 17th november 2011

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PPT used during training cum review of RSBY consultants held on 17th of November 2011 at Raipur

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Rsby for consultants review cum training 17th november 2011

  1. 1. Rashtriya Swasthya Bima Yojna in the State of Chhattisgarh28th June 2011 RSBY RRM Ranchi 1
  2. 2. Main features• Business Model for all Stakeholders• Empowering the beneficiary• Insurers• Hospitals• Government• IT based
  3. 3. IMPLEMENTATION OF THE SCHEME– Setting up of Nodal agency– Identification of Insurance agency– Appointment of DKM and FKOs– BPL data base– Enrollment of Beneficiaries and Delivery of Smart Card to commence– Empanelment of Government and private institutions– Payment of insurance premium to the insurance service provider.– Delivery of health services
  4. 4. 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  Additional CEO -functional or Executive CEO  Consultant- Hospital, Enrollment, M&E and Computer programmer  Accounts Manager and other support Staff.  District RSBY Consultant ( in position 17/18 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 areas17th November 2011 RSBY for consultants 4
  5. 5. www.rsby.in 4. Selection through tenderingGovernment State Nodal 9. Submission of data and bill Insurance of India Company Agency 10. Payment to Insurer BPL Data FKO Health Care Providers 8. Download of FKO Data at DKM server District Call Kiosk Centre 6. Issuance of BPL FKO Card Awareness Beneficiaries Health Camps DKM
  6. 6. Status of scheme• No of districts covered:- 18• Total BPL families enrolled till date:- 15,48,696• Total population enrolled:- 52,11,797• Avg. Family size:- 3.4• No of beneficiaries till date:- 1,43,849• Claim amount generated till date:- Rs.6328.22• Claim ratio:- 71.6• Burnout ratio:- 105.2• Hospitalization ratio:- Rs.4449.517th November 2011 For RSBY consultants 6
  7. 7. Moral hazards/ issues• At the time of enrollment• At the time of empanelment• For utilization of services
  8. 8. Going Beyond BPL• RSBY is being extended to other categories of Unorganized sector workers who are non-BPL • NREGA beneficiaries • Building and Construction Workers • Postman • ASHA Workers/ Mitanin • Anganwadi Workers • Non-Government sectors• In many of these categories people have agreed to pay part or full premium by themselves• Some other ministries are also contemplating to extend it to their targeted beneficiaries

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