Rashtriya Swasthya Bima Yojana – Performance Trends and Policy RecommendationsCIRM
India is characterized by modest health indicators, a paucity of medical financing schemes that have reached scale, high per capita out-of-pocket health expenditure, and very low public health spending on low-income citizens. The lack of financing options especially when the population is facing a double burden of disease (frequent communicable and catastrophic lifestyle diseases) leads to poor health outcomes and to poverty traps. Hence, optimal public health financing is important for improving national health outcomes and reducing vulnerability.
CMS: Proposed Physician Fee Schedule for CY 2021Jessica Parker
The Centers of Medicare and Medicaid Services (CMS) released the proposed physicians fee schedule for CY 2021 on Aug 3, 2020. Due to this proposal physicians will see a reduced conversion factor from $36.09 to $32.26, effective Jan. 1, 2021.
Healthcare Payer Services Market Research Report, 2024 | Grand View Research ...Uday M
Healthcare Payer Services Market Analysis By Outsourcing Services (BPO, ITO, KPO), By Application (Claims Management Services, Integrated Front Office Service And Back Office Operations, Member Management Services, Provider Management Services, Billing And Accounts Management Services, Analytics And Fraud Management Services, HR Services), By End Use (Private Payers, Public Payers), And Segment Forecasts To 2024
Rashtriya Swasthya Bima Yojana – Performance Trends and Policy RecommendationsCIRM
India is characterized by modest health indicators, a paucity of medical financing schemes that have reached scale, high per capita out-of-pocket health expenditure, and very low public health spending on low-income citizens. The lack of financing options especially when the population is facing a double burden of disease (frequent communicable and catastrophic lifestyle diseases) leads to poor health outcomes and to poverty traps. Hence, optimal public health financing is important for improving national health outcomes and reducing vulnerability.
CMS: Proposed Physician Fee Schedule for CY 2021Jessica Parker
The Centers of Medicare and Medicaid Services (CMS) released the proposed physicians fee schedule for CY 2021 on Aug 3, 2020. Due to this proposal physicians will see a reduced conversion factor from $36.09 to $32.26, effective Jan. 1, 2021.
Healthcare Payer Services Market Research Report, 2024 | Grand View Research ...Uday M
Healthcare Payer Services Market Analysis By Outsourcing Services (BPO, ITO, KPO), By Application (Claims Management Services, Integrated Front Office Service And Back Office Operations, Member Management Services, Provider Management Services, Billing And Accounts Management Services, Analytics And Fraud Management Services, HR Services), By End Use (Private Payers, Public Payers), And Segment Forecasts To 2024
This presentation provides an overview of current licensure requirements for telemedicine in Michigan. In addition, this presentation discusses how state licensure requirements present barriers to telemedicine practice in Michigan and strategies to overcome barriers in the state.
The 2021 Hospital Inpatient Prospective Payment System (IPPS) Final Rule has been issued and changes are on the way that can affect your organization’s Medicare reimbursement. As part of our commitment to help protect and enhance your Medicare revenue, we’ve developed this expert analysis of the FY 2021 IPPS Final Rule to quickly give you insight into the most important changes. BESLER remains your trusted advisor and we look forward to helping you identify areas of revenue opportunity for your facility.
By Venkitasubramanian Akshay
When it comes to healthcare, there are two India's – a country that provides state of the art medical care to middle-class Indians and attracts medical tourists; and another where a majority of its own citizens cannot afford or even get access to basic healthcare.
The 2020 Hospital Outpatient Prospective Payment System (OPPS) Final Rule has been issued and changes are on the way that can affect your organization’s Medicare reimbursement.
As part of our commitment to help protect and enhance your Medicare revenue, we’ve developed this expert analysis of the FY 2020 OPPS Final Rule to quickly give you insight into the most important changes.
BESLER remains your trusted advisor and we look forward to helping you identify areas of revenue opportunity for your facility.
Annually, CMS proposes changes to the Inpatient Prospective Payment System (IPPS) rules that can impact how IPPS facilities are reimbursed from Medicare – either positively or negatively.
Proposed updates are posted in April and issued as a final rule in October of each year. Because IPPS hospitals are paid based on Medicare Severity Diagnosis Related Groups (MS-DRG), additions, deletions, or alterations to MS DRGs can affect how hospitals should submit claims to Medicare.
This presentation provides an overview of current licensure requirements for telemedicine in Michigan. In addition, this presentation discusses how state licensure requirements present barriers to telemedicine practice in Michigan and strategies to overcome barriers in the state.
The 2021 Hospital Inpatient Prospective Payment System (IPPS) Final Rule has been issued and changes are on the way that can affect your organization’s Medicare reimbursement. As part of our commitment to help protect and enhance your Medicare revenue, we’ve developed this expert analysis of the FY 2021 IPPS Final Rule to quickly give you insight into the most important changes. BESLER remains your trusted advisor and we look forward to helping you identify areas of revenue opportunity for your facility.
By Venkitasubramanian Akshay
When it comes to healthcare, there are two India's – a country that provides state of the art medical care to middle-class Indians and attracts medical tourists; and another where a majority of its own citizens cannot afford or even get access to basic healthcare.
The 2020 Hospital Outpatient Prospective Payment System (OPPS) Final Rule has been issued and changes are on the way that can affect your organization’s Medicare reimbursement.
As part of our commitment to help protect and enhance your Medicare revenue, we’ve developed this expert analysis of the FY 2020 OPPS Final Rule to quickly give you insight into the most important changes.
BESLER remains your trusted advisor and we look forward to helping you identify areas of revenue opportunity for your facility.
Annually, CMS proposes changes to the Inpatient Prospective Payment System (IPPS) rules that can impact how IPPS facilities are reimbursed from Medicare – either positively or negatively.
Proposed updates are posted in April and issued as a final rule in October of each year. Because IPPS hospitals are paid based on Medicare Severity Diagnosis Related Groups (MS-DRG), additions, deletions, or alterations to MS DRGs can affect how hospitals should submit claims to Medicare.
Profiling is a description of a customer or set of customers that includes demographic, geographic, and psychographic characteristics.
Customer profile is needed when you are trying to market your product.
Government insurance and pension scheme as PMSBY, PMJBY and APY are new security based bank products introduced to market.
Bancassurance : 3 règles d’or pour une stratégie de communication digitale ef...Soyuz
Comment mettre en place une stratégie de communication digitale efficace dans un secteur qui privilégie très souvent le SEO ?
Découvrez nos trois règles d'or pour améliorer votre attractivité, en :
1/ Redéfinissant votre identité de marque, dans un contexte d'érosion d'image de la bancassurance
2/ Créant un lien émotionnel pour renforcer la relation client
3/ Délivrant des contenus plus intelligents grâce à des outils d'organisation et de production
Cette présentation vous permettra de définir au mieux votre stratégie : où parler, à qui, comment ?
CARD MBA experience on its microinsurance program: How can mutual insurance l...ICMIF Microinsurance
Presentation made by May Dawat (General Manager, CARD MBA, The Philippines) at the 6th ICMIF Development Network Seminar (1-2 November 2012; Nairobi, Kenya)
Indian Insurance Industry - Recent Industry Trends - Part - 5Resurgent India
Bancassurance means selling insurance product through banks. Banks and insurance company come up in a partnership wherein the bank sells the tied insurance company's insurance products to its clients. Globally, bancassurance has emerged as an important channel for distribution of insurance products. Various international studies have shown that a bancassurance strategy has indeed saved costs of insurance companies in the long run.
India is the global leader in microinsurance. Innovation is blooming and new products and delivery models are being explored. More than 300 million low-income risks are insured. Indeed, more than 60% of microinsurance policyholders are to be found in India! What are the catalysts for the success of microinsurance in India? What role has the government as well as market forces played in the exponential growth of the sector? What can insurers learn from India's experience? The webinar focuses on "Insights from India's Microinsurance Success", one of the chapters of the newly launched "Protecting the Poor: A Microinsurance Compendium, Volume II" published by the Munich Re Foundation and the International Labour Office.
Mr Anil Swarup Dir General, Ministry of Labour & Development, Govt of India presented on the biggest health insurance scheme (RSBY) run by the government at a seminar hosted by CIRM in Chennai, India
Geriatric Care Services Market PPT 2022: Size, Growth, Demand and Forecast ti...IMARC Group
According to the latest report by IMARC Group, the global geriatric care services market reached a value of US$ 997.3 Billion in 2021. Geriatric care services refer to medical facilities providing health and wellness services for the elderly. Nutritional services, home care, medications, socialization programs and non-medical services, such as homemaking, personal care, meals and grocery are some of the commonly offered services.
Insurance market Brazil 2015 - UBS Presentationsamyseg
M&A activities and New Insurance Companies in Brazil
Brazilian Insurance Ecosystem Overview
Growth, Margin and Profitability Analysis
Main types of Players and Market Share by Business Model
Crop Insurance, the Backbone of Indian farming communityIssues and ChallengesIJERA Editor
The dynamism of the farming sector, and its environment, is reflected in developments in the design of new
insurance products. In the last decade two types of new products have been introduced. In some cases these have
partially displaced existing covers; in others they have resulted in demand from new clients. Implementation of
technology in farming usually involves investment. Such changes also frequently alter the risk profile of the
enterprise. There are occasions when insurance can be a key component in a range of risk management
strategies for the insurers. From an administrative point of view bank-insurer linkages make a lot of sense, since
both these providers of financial services require similar client data.
This type of link, crop insurance and loans, is already very common, both in developing and developed
agriculture. The vast, heavily subsidized scheme in India is largely linked to bank lending. So instead of the
usual policy wording, such as indemnity, or range of indemnity levels, or a per hectare basis for a given crop,
for losses from specific causes, the coupon merely gives a monetary sum which becomes payable on
certification that the named weather event, of specified severity, has occurred. Again the role of state is very
important making available crop insurance on a large scale, as they are public good in nature. Recently in
Odisha, for crops such as Niger, cotton, red grams, jute, turmeric, ginger and banana, the farmers of selected
blocks in some district could take advantage of the scheme. Because indemnity claim is settled only on the basis
of yield data furnished by the State government. Hence the criteria that is based on requisite number of crop
cutting experiments conducted under general crop estimation surveys should be supported by State to offer
desired result in crop insurance.
RSBY was launched in early 2008 and was initially designed to target only the Below Poverty Line (BPL) households, but has been expanded to cover other defined categories of unorganized
Consumer Credit Market PPT: Growth, Outlook, Demand, Keyplayer Analysis and O...IMARC Group
The global consumer credit market size reached US$ 11.0 Billion in 2022. Looking forward, IMARC Group expects the market to reach US$ 14.5 Billion by 2028, exhibiting a growth rate (CAGR) of 4.8% during 2023-2028.
More Info:- https://www.imarcgroup.com/consumer-credit-market
Crop Insurance Market Growth, Demand and Challenges of the Key Industry Playe...IMARC Group
The global crop insurance market size reached US$ 43.7 Billion in 2023. Looking forward, IMARC Group expects the market to reach US$ 69.9 Billion by 2032, exhibiting a growth rate (CAGR) of 5.1% during 2024-2032.
More Info:- https://www.imarcgroup.com/crop-insurance-market
Insights into the 2020 individual marketplace—increase consumer choice and de...Kim Simoniello
This analysis reflects carrier participation, pricing, and plan type trends for the 2020 individual exchange open enrollment period. Findings are across 50 states and DC.
Challenges faced by Health Insurance industry in India and some suggestions to overcome these challenges. with conceptual clarity about health insurance sector.
Consumer Credit Market PPT: Demand, Trends and Business Opportunities 2022-27IMARC Group
Looking forward, the consumer credit market value is projected to reach a strong growth during the forecast period (2022-2027).
More info:- https://www.imarcgroup.com/consumer-credit-market
Aarong's Tanvir Hossain presents at Social Innovation Lab's Innovation Forum on "Breaking down the silos: Lessons from cross-porgramme initiatives at BRAC"
US Economic Outlook - Being Decided - M Capital Group August 2021.pdfpchutichetpong
The U.S. economy is continuing its impressive recovery from the COVID-19 pandemic and not slowing down despite re-occurring bumps. The U.S. savings rate reached its highest ever recorded level at 34% in April 2020 and Americans seem ready to spend. The sectors that had been hurt the most by the pandemic specifically reduced consumer spending, like retail, leisure, hospitality, and travel, are now experiencing massive growth in revenue and job openings.
Could this growth lead to a “Roaring Twenties”? As quickly as the U.S. economy contracted, experiencing a 9.1% drop in economic output relative to the business cycle in Q2 2020, the largest in recorded history, it has rebounded beyond expectations. This surprising growth seems to be fueled by the U.S. government’s aggressive fiscal and monetary policies, and an increase in consumer spending as mobility restrictions are lifted. Unemployment rates between June 2020 and June 2021 decreased by 5.2%, while the demand for labor is increasing, coupled with increasing wages to incentivize Americans to rejoin the labor force. Schools and businesses are expected to fully reopen soon. In parallel, vaccination rates across the country and the world continue to rise, with full vaccination rates of 50% and 14.8% respectively.
However, it is not completely smooth sailing from here. According to M Capital Group, the main risks that threaten the continued growth of the U.S. economy are inflation, unsettled trade relations, and another wave of Covid-19 mutations that could shut down the world again. Have we learned from the past year of COVID-19 and adapted our economy accordingly?
“In order for the U.S. economy to continue growing, whether there is another wave or not, the U.S. needs to focus on diversifying supply chains, supporting business investment, and maintaining consumer spending,” says Grace Feeley, a research analyst at M Capital Group.
While the economic indicators are positive, the risks are coming closer to manifesting and threatening such growth. The new variants spreading throughout the world, Delta, Lambda, and Gamma, are vaccine-resistant and muddy the predictions made about the economy and health of the country. These variants bring back the feeling of uncertainty that has wreaked havoc not only on the stock market but the mindset of people around the world. MCG provides unique insight on how to mitigate these risks to possibly ensure a bright economic future.
Poonawalla Fincorp and IndusInd Bank Introduce New Co-Branded Credit Cardnickysharmasucks
The unveiling of the IndusInd Bank Poonawalla Fincorp eLITE RuPay Platinum Credit Card marks a notable milestone in the Indian financial landscape, showcasing a successful partnership between two leading institutions, Poonawalla Fincorp and IndusInd Bank. This co-branded credit card not only offers users a plethora of benefits but also reflects a commitment to innovation and adaptation. With a focus on providing value-driven and customer-centric solutions, this launch represents more than just a new product—it signifies a step towards redefining the banking experience for millions. Promising convenience, rewards, and a touch of luxury in everyday financial transactions, this collaboration aims to cater to the evolving needs of customers and set new standards in the industry.
how to sell pi coins effectively (from 50 - 100k pi)DOT TECH
Anywhere in the world, including Africa, America, and Europe, you can sell Pi Network Coins online and receive cash through online payment options.
Pi has not yet been launched on any exchange because we are currently using the confined Mainnet. The planned launch date for Pi is June 28, 2026.
Reselling to investors who want to hold until the mainnet launch in 2026 is currently the sole way to sell.
Consequently, right now. All you need to do is select the right pi network provider.
Who is a pi merchant?
An individual who buys coins from miners on the pi network and resells them to investors hoping to hang onto them until the mainnet is launched is known as a pi merchant.
debuts.
I'll provide you the Telegram username
@Pi_vendor_247
Turin Startup Ecosystem 2024 - Ricerca sulle Startup e il Sistema dell'Innov...Quotidiano Piemontese
Turin Startup Ecosystem 2024
Una ricerca de il Club degli Investitori, in collaborazione con ToTeM Torino Tech Map e con il supporto della ESCP Business School e di Growth Capital
what is the best method to sell pi coins in 2024DOT TECH
The best way to sell your pi coins safely is trading with an exchange..but since pi is not launched in any exchange, and second option is through a VERIFIED pi merchant.
Who is a pi merchant?
A pi merchant is someone who buys pi coins from miners and pioneers and resell them to Investors looking forward to hold massive amounts before mainnet launch in 2026.
I will leave the telegram contact of my personal pi merchant to trade pi coins with.
@Pi_vendor_247
What price will pi network be listed on exchangesDOT TECH
The rate at which pi will be listed is practically unknown. But due to speculations surrounding it the predicted rate is tends to be from 30$ — 50$.
So if you are interested in selling your pi network coins at a high rate tho. Or you can't wait till the mainnet launch in 2026. You can easily trade your pi coins with a merchant.
A merchant is someone who buys pi coins from miners and resell them to Investors looking forward to hold massive quantities till mainnet launch.
I will leave the telegram contact of my personal pi vendor to trade with.
@Pi_vendor_247
What website can I sell pi coins securely.DOT TECH
Currently there are no website or exchange that allow buying or selling of pi coins..
But you can still easily sell pi coins, by reselling it to exchanges/crypto whales interested in holding thousands of pi coins before the mainnet launch.
Who is a pi merchant?
A pi merchant is someone who buys pi coins from miners and resell to these crypto whales and holders of pi..
This is because pi network is not doing any pre-sale. The only way exchanges can get pi is by buying from miners and pi merchants stands in between the miners and the exchanges.
How can I sell my pi coins?
Selling pi coins is really easy, but first you need to migrate to mainnet wallet before you can do that. I will leave the telegram contact of my personal pi merchant to trade with.
Tele-gram.
@Pi_vendor_247
If you are looking for a pi coin investor. Then look no further because I have the right one he is a pi vendor (he buy and resell to whales in China). I met him on a crypto conference and ever since I and my friends have sold more than 10k pi coins to him And he bought all and still want more. I will drop his telegram handle below just send him a message.
@Pi_vendor_247
Introduction to Indian Financial System ()Avanish Goel
The financial system of a country is an important tool for economic development of the country, as it helps in creation of wealth by linking savings with investments.
It facilitates the flow of funds form the households (savers) to business firms (investors) to aid in wealth creation and development of both the parties
how to sell pi coins in South Korea profitably.DOT TECH
Yes. You can sell your pi network coins in South Korea or any other country, by finding a verified pi merchant
What is a verified pi merchant?
Since pi network is not launched yet on any exchange, the only way you can sell pi coins is by selling to a verified pi merchant, and this is because pi network is not launched yet on any exchange and no pre-sale or ico offerings Is done on pi.
Since there is no pre-sale, the only way exchanges can get pi is by buying from miners. So a pi merchant facilitates these transactions by acting as a bridge for both transactions.
How can i find a pi vendor/merchant?
Well for those who haven't traded with a pi merchant or who don't already have one. I will leave the telegram id of my personal pi merchant who i trade pi with.
Tele gram: @Pi_vendor_247
#pi #sell #nigeria #pinetwork #picoins #sellpi #Nigerian #tradepi #pinetworkcoins #sellmypi
BYD SWOT Analysis and In-Depth Insights 2024.pptxmikemetalprod
Indepth analysis of the BYD 2024
BYD (Build Your Dreams) is a Chinese automaker and battery manufacturer that has snowballed over the past two decades to become a significant player in electric vehicles and global clean energy technology.
This SWOT analysis examines BYD's strengths, weaknesses, opportunities, and threats as it competes in the fast-changing automotive and energy storage industries.
Founded in 1995 and headquartered in Shenzhen, BYD started as a battery company before expanding into automobiles in the early 2000s.
Initially manufacturing gasoline-powered vehicles, BYD focused on plug-in hybrid and fully electric vehicles, leveraging its expertise in battery technology.
Today, BYD is the world’s largest electric vehicle manufacturer, delivering over 1.2 million electric cars globally. The company also produces electric buses, trucks, forklifts, and rail transit.
On the energy side, BYD is a major supplier of rechargeable batteries for cell phones, laptops, electric vehicles, and energy storage systems.
how to swap pi coins to foreign currency withdrawable.DOT TECH
As of my last update, Pi is still in the testing phase and is not tradable on any exchanges.
However, Pi Network has announced plans to launch its Testnet and Mainnet in the future, which may include listing Pi on exchanges.
The current method for selling pi coins involves exchanging them with a pi vendor who purchases pi coins for investment reasons.
If you want to sell your pi coins, reach out to a pi vendor and sell them to anyone looking to sell pi coins from any country around the globe.
Below is the contact information for my personal pi vendor.
Telegram: @Pi_vendor_247
Exploring Abhay Bhutada’s Views After Poonawalla Fincorp’s Collaboration With...beulahfernandes8
The financial landscape in India has witnessed a significant development with the recent collaboration between Poonawalla Fincorp and IndusInd Bank.
The launch of the co-branded credit card, the IndusInd Bank Poonawalla Fincorp eLITE RuPay Platinum Credit Card, marks a major milestone for both entities.
This strategic move aims to redefine and elevate the banking experience for customers.
Addressing vulnerability through microinsurance (1)
1. Addressing Vulnerability through Micro
Insurance?
Stories of impact and viability
BRAC,
15th July, 2013
By Rupalee Ruchismita, Director
CIRM-Design and Research Labs
2. Improving financial protection
for Preserving and Productive activities
Focus on:
- Products and Process
- Life, Health, Agriculture and Livestock
- Role of Intermediaries
- Showcasing Innovation
3. Defining the Microinsurance Space
1. MiM relies on Industry data reported under IRDA regulation (as under MI Act 2005 and under the Rural and Social
Obligations)
2. Under the IRDA regulations, reported data includes products served to RED PLUS GREEN
3. Hence, Microinsurance Maps also presents data for RED PLUS GREEN
4. Ideally it should report for products offered to GREEN
* LIG: Low Income Groups
* IRDA: Insurance Regulatory and Development Authority
1. MiM relies on Industry data reported under IRDA regulation (as under MI Act 2005 and under the Rural and Social
Obligations)
2. Under the IRDA regulations, reported data includes products served to RED PLUS GREEN
3. Hence, Microinsurance Maps also presents data for RED PLUS GREEN
4. Ideally it should report for products offered to GREEN
* LIG: Low Income Groups
* IRDA: Insurance Regulatory and Development Authority
4. State and Center supported health insurance schemes have
contributed to the portfolio increase
Has the insurance industry discovered a sustainable business case for
the rural and social sector?
Tracking impact of Rural and Social Sector Targets
5. • Life Insurers: The rural portfolio has grown steadily exceeding
regulatory targets!
• Whereas, the MI portfolio remains insignificant
Need for revisiting MI Act 2005?
Tracking impact of Micro Insurance Act, 2005
6. • General Insurance: Sudden growth in overall rural and social
business from 2008-09 to 2009-10 even though number of
insurance companies has remained
• The rural portfolio has grown steadily exceeding regulatory
targets!
Tracking impact of Rural and Social Sector Targets
7. • MI Act,2005: Maximum MI products registered in 2007-08
• Sharp fall in Life MI product registration since then!
Tracking impact of Micro Insurance Act, 2005
18. Mass health insurance
The Story of scale
Features
Name of the Scheme
Yeshasvini Co-operative
Farmers Health care
Scheme (Karnataka) 2003
Aarogyasri Community
Health Insurance scheme
(AP) 2007
Rashtriya Swasthya Bima
Yojana (RSBY) 2008
Kalaignar's Insurance
Scheme for Life saving
Treatments (TN) 2009
Unit of enrolment (families,
individuals, etc.)
Individuals Families
Sources of Funds
Contribution: Beneficiary
58% + Government 42% (in
2009-10)
by State
$0.6 by beneficiary
+75% by Centre and
25% by State
government
by State
Premium Rate in 2009-10 $3.3 per person $6 per family Avg. $12 per family $10 per family
Maximum insurance cover $4444 per person
$3333 per family with
additional buffer of $1111
$666 per family
$2222 over 4 years, per
family
Commonest procedures
Cardiac, ENT, General
Surgery, Paediatric,
Obstetric, Ophthalmic
procedures.
Oncology, CVS, Polytrauma,
Genitourinary surgeries,
General surgeries
Medical Treatment,
Ophthalmic
procedures, Neurology,
Infectious Diseases,
Gynae & Obstetric
procedures.
Orthopaedic, Oncology,
urology, ENT,
Cardiology,
Hysterectomy and
Ophthalmology
19. Mass health insurance
The Story of scale
Management
Name of the
Scheme
Yeshasvini Co-operative
Farmers Scheme
Aarogyasri
Rashtriya Swasthya Bima
Yogna (RSBY)
Kalaignar's for Life saving
Treatments (TN)
IT tools used
Electronic claims submission
software in all network
hospitals, linked to TPA's
systems.
Comprehensive MIS,,
electronic operation and
payments, Digital signature
for all users, electronic claims
process including
requirement for patient
photographs pre and post
procedure et
Photos and biometric data
of families collected on
smart chip at enrolment,
Smart cards enable offline
authorization and batch
transfer of data
Web based pre authorization
and claim submission Digital
smart card to identify the
beneficiary. Web cams for co-
ordination and monitoring of
Liaison Officers in network
hospitals
Cost containment
measures
Scrutiny and second opinion
are obtained before giving
Preauthorization.
Verification of High-end
surgeries, Scrutiny by TPA as
well CA of Trust
Prior authorization, package
rates, MIS, monitoring
Surveillance and medical
vigilance teams,
Aarogyamithras in hospitals
Smart card for identity
verification and prior
authorisation closed ended
package rates for common
procedures. In-depth
analysis of claim
experience
Pre-authorization, screening
through health camps,
package cost, In-depth analysis
of claims, discharge planning
with LO's
Utilization rate Avg Claims ration is 157%
Claims frequency is about
1.6% perfamily, claim ratio is
between 69.6% to 128.3%
(89%)
Avg Claim ratio was about
80% in 2009-10
80% Claims Ratio
20. Mass health insurance
The Story of scale
Performance
Name of the Scheme
Yeshasvini Co-
operative Farmers
Scheme
Aarogyasri
Rashtriya Swasthya Bima
Yogna (RSBY)
Kalaignar's for Life saving
Treatments (TN)
Avg. Cost per
Hospitalization
8240 27848 4262 33720
Number of
Hospitalization per
1000 person
22 5 25 4
Utilization rate
Avg Claims ratio is
157%
Claims frequency is about
1.6% perfamily, claim ratio
is between 69.6% to 128.3%
(89%)
Avg Claim ratio was about
80% in 2009-10
80% Claims Ratio
21. RSBY
Key characteristics
• RSBY is the Indian Central Government’s in-patient health insurance
scheme that covers secondary care for Below Poverty Line families
launched in 2008
• Premiums range from USD 7-15 for a sum assured of USD 666 per
family
• Enrolment occurs in camps, where beneficiaries are issued a smart
card and a policy. Customers pay Rs30 for the policy
• Premium of USD 222 million has been paid by the Government, with
insurers paying out close to USD 200 million for 1.5 Million
hospitalization cases
• Phased roll out of RSBY's impact on KPIs
• Conversion ratio, Hospitalisation ratio,Total Expense Ratio
• Followed it with a out-of pocket health expenditure with difference in
difference approach with matching-Used NSSO data.
3
22. RSBY
Key characteristics: Outreach
• As of May 2011, RSBY has reached
• 18 million smart cards covering approximately 47 million individuals
• Since inception in 2008,
• The scheme has been launched in 229 districts in 22 states,
• With 47 districts having completed two years of operation
• Average amount claimed per year the hospitalized: USD 100
• By Feb , 2012,RSBY reached
27 million households in 24 states (396 districts) and 32
million
23. Spreading the risk through partnership :
Multiple insurance and TPA partners
• Insurers:
• Eight insurers bid on year 1,
with three public insurers.
• Out of 8 insurers operating,
ICICI Lombard, New India
and Oriental account for
over 75% of the districts
covered.
• TPAs:
• Sixteen TPAs with FINO
having the largest followed
by E-Meditek and MD India.
1 17
91
58
31
3
10
18
Apollo Munich
Cholamandalam MS GIC
ICICI Lombard
New India Assurance Co. Ltd.
Oriental Insurance Company Ltd.
Royal Sundaram
Tata AIG
United India Insurance
24. Localised pricing:
District specific premiums through bidding
• Insurers:
• Eight insurers bid in Year
1, with three public
insurers.
• Out of 8 insurers
operating, ICICI Lombard,
New India and Oriental
account for over 75% of
the districts covered.
• TPAs:
• Sixteen TPAs with FINO
having the largest
followed by E-Meditek and
MD India.
516
623
554
626
596
537
0 200 400 600
Premium(Rs.)
RoyalSundaram
OrientalInsuranceCompanyLtd.
NewIndiaAssuranceCo. Ltd.
ICICILombard
Cholamandalam MS GeneralIns.Co. Ltd.
ApolloMunich
5
25. Examining RSBY
Key Performance Indicators against Social Demographic realities
as on May 2011
CIRM uses:
•RSBY: Year 1 and Year 2 (as of May, 2011)
• District level administrative data
• Client level utilisation data
•Secondary Socio Demographic:
• National Sample Survey and
• District Level Household Survey
25
26. Examining RSBY
Conversion Ratio:
Households enrolled into RSBY against total BPL families per district
• Modest Conversion ratio
at 51.2% in Year 1
• Significant variation across
states and districts
• Ranges from over 80% in
Tripura and Himachal
Pradesh to less than 35% in
Assam, Jharkhand, and
Tamil Nadu
Factors like poor habitation to
road ratio in rural regions
and high commuter and
seasonal migrants could be
the cause in urban regions
68
46
53
87
33
39
56
79
54
47
44
47
35
60
83
56
50
53
68
56
11
0 20 40 60 80
Average Conversion Ratio (%)
West Bengal
Uttarakhand
U.P.
Tripura
Tamil Nadu
Punjab
Orissa
Nagaland
Meghalaya
Maharashtra
Kerala
Karnataka
Jharkhand
Haryana
HP
Gujarat
Goa
Chhattisgarh
Chandigarh
Bihar
Assam
27. Examining RSBY
Conversion Ratio: What affects it
Correlation with socio demographic and programmatic factors
• Higher Conversion correlated to:
• Literacy and education rates in the
district: While the ratio is 45%
amongst districts in the lower
percentile by literacy, this rises to 56%
amongst the more educated districts
• More males than females
• Year 1 male to female conversion is
169% not correlated to district sex
ratio
• Choice of TPA matters more than
insurer: Management not capital
• Significant variation in conversion
rates, implying “Ability and effort of
TPA accounts for part of the
variation in conversion ratios” 16
3
7
11
13
4
3
17
2
1
91
1
10
34
1
7
0 20 40 60 80 100
TPAs in Round 1
Vipul Med
TTK
Smartchip
Safeway
Medsave
Medicare
Mediassist
MD India
Kyros
Genins India
Fino
Family Health Plan
Eagle
E-Meditek
Dedicated Health Service
Alankit
28. Examining RSBY
Incidence rate: Recommendations
• Conversion Ratios decrease with the size of the district :
• May be due to increased difficulty for the TPA to manage a larger district
• Wait times may have been higher in more crowded camps
• Bigger districts are most often geographically more spread out
There is a case for :
• Subdividing larger districts
• Allowing more enrolment time and
• Greater incentives to TPAs and Insurers to increase conversion rates
29. Examining RSBY
Hospitalisation ratio or Incidence rate
• Hospitalization or Incidence rate is
2.4% in Year 1, implying low
utilisation:
• Opposed to 2.3% historically for all income
groups and without insurance
• Significant variation across states and
districts: Ranging from 5.2% in Kerala to
less than 0.1% in Assam and Chandigarh
• Variation high between insurers:
• Not statistically significant,
Suggesting other socio demographic
factors driving variation in Incidence Rate
1.2
1.4
3.5
2.7
2.6
.99
.69
2.8
.63
1.8
5.2
.93
1.1
2.8
1.4
4.3
.11
3.6
.92
.077
1.4
.094
0 1 2 3 4 5
Hospitalization Ratio - Year 1 (%)
West Bengal
Uttarakhand
U.P.
Tripura
Tamil Nadu
Punjab
Orissa
Nagaland
Meghalaya
Maharashtra
Kerala
Karnataka
Jharkhand
Haryana
HP
Gujarat
Goa
Delhi
Chhattisgarh
Chandigarh
Bihar
Assam
30. Examining RSBY
Hospitalisation ratio or Incidence rate: What affects it
Incidence rate is correlated to:
• TPAs matter
• Higher Literacy levels in a district imply
greater incidence rate
• Greater percentage of private hospitals
imply higher Incidence rate: This may be
due to:
• The perceived better quality as well as actual
availability of doctors and consumables in
private facilities
•Gender:
• A greater percentage of enrolled women are
using RSBY services
•Use of good primary care appears to
reduce hospitalization rate
• There is a 0.02% decrease in hospitalization in a
district if there is a 1% increase in per capita
Primary Care usage
2.3
4.9
1.4
1.9
2.5
.93
1.3
3.4
1.6
1
3.2
.63
2
1.3
6.5
2.4
0 2 4 6
Hospitalization Ratio - Year 1 (%)
VipulMed
TTK
Smartchip
Safeway
Medsave
Medicare
Mediassist
MD India
Kyros
Genins India
Fino
Family Health Plan
Eagle
E-Meditek
Dedicated HealthService
Alankit
31. Examining RSBY
Incidence rate: Recommendations
There is an encouraging case for :
•Governments to improve primary care facilities as it contributes to longer
term sustainability of inpatient insurance programmes
•Insurance programme seems to address household level neglect of
women health needs
•Greater incentives to public hospitals to improve perceived perception
among users
32. Examining RSBY
Incentive alignment for insurers
• Year 1 was profitable for insurers:
• Average burn-out ratio of 77% (Claims of 49%,
smart card costs of 17%, service tax of 11%)
• 23% of the total premium remained with the
insurer
32 78
50
85
65
47
57
37
136
39
64
100
56
64
82
78
128
28
116
48
33
70
28
0 50 100 150
Burn Out Ratio - Year 1 (%)
West Bengal
Uttarakhand
U.P.
Tripura
Tamil Nadu
Punjab
Orissa
Nagaland
Meghalaya
Maharashtra
Kerala
Karnataka
Jharkhand
Haryana
HP
Gujarat
Goa
Delhi
Chhattisgarh
Chandigarh
Bihar
Assam
• There is however large variations
between state and districts and
between insurers
• Districts with burn-out ratio of more than
100% have marginally lower premium
(USD 12vsUSD 13) but considerably
higher hospitalization rates (5.6%
compared to 1.6%)
34. Stakeholder Value: Solutions for Policy
Makers
Use
• Monitor impact of regulation on providers and products
Benefit
• Create industry benchmarks on product, process and
service quality
• Identify early trends (sectors trends and also for specific
providers and risk categories) to respond accordingly
• Make proactive regulation and policy for underserved
regions and track its impact on the market
35. Stakeholder Value: Solutions for Insurers
Use
• Disaggregated region specific risk data to develop actuarially sound
product pricing
• Market insight for development of outreach strategies – competitor
and profitability analysis, exposure to innovative product and
processes
Benefit
• Public platform to market products, find potential intermediaries, new
relations (IT providers, TPAs)
• Plan market entry based on a range of factors- geographical,
distribution models, risk specific and competitor based analysis
• Market assessment – Updated about ‘sector news’; Trend analyses
(over years, regions, risk type and market players)
• Own portfolio monitoring, analysis and tracking
36. Stakeholder Value: Solutions for
Intermediaries (Co-ops, NGOs, MFI)
Use
• Reports to compare pricing and features of own product
by various criteria (region, risk type and insurer, premium
and claims)
Benefit
• Use sector best practices to measure own and partner’s
(insurer) service quality
• Improve own visibility to find partners
• Assess insurers based on products and performance
37. Centre for Insurance and Risk Management
• Established in 2006 as a specialized design and research centre at the
Institute of Financial Management and Research (IFMR)
• Committed to undertaking product design and action research to
facilitate greater market outreach of risk management solutions among
vulnerable households
Focus areas
• Product Innovation
Action Research
Product Development
• Market Making
Data Warehousing
Training
Policy Advocacy
Verticals
• Agriculture
• Livestock
• Health
• Catastrophe
• Life
• Life term Savings/Annuities
Safety Nets for All
38. Data Sources
Market Data
• Regulator (IRDA)
• Industry Associations
• Insurers - public and private, life and general
• Mutual and intermediaries - MFIs, Cooperatives, NGOs, input and output
suppliers (on going)
Risk data on regional basis
• Indian Meteorological Department, Central Water Commission, Actuaries
Association of India, Govt. Dept. of Agriculture, National Remote Sensing Centre,
Agriculture Universities
• Veterinary Universities
42. Next Steps
• Technical Content
•
• Event microsite and Publications
• Event Report
• Photos and Videos
• Video Interviews
Keeping the discussion going:
• Group mail
• Blog, Linkedin, Facebook
Safety Nets for All
is this more than the PST? And if so, exceeded by what percentage?
This to be ratified by henna
This is free programme, so whya re people not enrolling? There is a negative correlation between the number of BPL families in the district and conversion. We see that while the average conversion ratio is 55% for the top 2 quartiles by district size, it comes down to 50% in the bottom half. This may be because it is more difficult for the TPA to manage a larger district operationally, because the wait times may have been higher in more crowded camps or because bigger districts are more spread out and hence more distant for the TPA. There is a case for subdividing larger districts or to put in place other policies to improve conversion rates in larger districts
It ranges from 32% in the case of Alankit to 70% with Kyros.