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
The National Health Mission (NHM) encompasses
its two Sub-Missions, the National Rural Health
Mission (NRHM) and the National Urban Health
Mission (NUHM). The main programmatic
components include Health system strengthening
in rural and urban areas, ReproductiveMaternal-Neonatal-Child and Adolescent Health
(RMNCH+A) and Communicable and NonCommunicable Diseases. The NHM envisages
achievement of universal access to equitable,
affordable & quality healthcare services that are
accountable and responsive to people’s needs.
The National Health Mission (NHM) encompasses
its two Sub-Missions, the National Rural Health
Mission (NRHM) and the National Urban Health
Mission (NUHM). The main programmatic
components include Health system strengthening
in rural and urban areas, ReproductiveMaternal-Neonatal-Child and Adolescent Health
(RMNCH+A) and Communicable and NonCommunicable Diseases. The NHM envisages
achievement of universal access to equitable,
affordable & quality healthcare services that are
accountable and responsive to people’s needs.
Launched as recommended by the national health policy 2017
To achieve the vision of universal health coverage (UHC).
This initiative has been designed to meet Sustainable Development Goals (SDGs) and its underlining commitment, which is to "leave no one behind.“
Ayushman bharat what an why ..we must know this programme it is important for all doctors and nurses and others...very important for MBBS students also
A new group of healthcare professionals who are not doctors are called community health officers CHOs . As a part of Comprehensive Primary Health Care, CHOs will be vital in providing an increased range of essential services. They are expected to direct the primary care staff at the Sub Centre, Health and Wellness Center, offer ambulatory care and clinical management to the neighborhood, and act as a crucial coordination link to guarantee the continuum of car. Mr. Saneesh CM | Dr. S. Victor Devasirvadam "Community Health Officer (CHO): An Overview" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-7 | Issue-1 , February 2023, URL: https://www.ijtsrd.com/papers/ijtsrd53840.pdf Paper URL: https://www.ijtsrd.com/medicine/nursing/53840/community-health-officer-cho-an-overview/mr-saneesh-cm
Health workforce Statistics: Current Needs and Requirements
Introduction
Trained healthcare workforce is an important determinant of efficiency and outcomes of any health system as devised by WHO health systems approach. India one of the most populous country of the world has always felt a dire need of healthcare workforce even having one of the largest medical education and capacity building system. On the other hand we have a variety of health cadre namely from an ASHA to super specialized doctors. In our presentation we have critically analyzed the distribution of health workforce in India and its impacts on health and healthcare delivery for the mass of our society.
The Health Workforce in Nutshell
India faces an acute shortage of trained health workforce. India has a large basket of interventions to improve the healthcare but they are adversely effected by shortage of trained, motivated and supported health workforce. The shortages and misdistribution of health workforce have a large contribution to inequities in health outcomes. India’s health workforce is a combination of both registered, formal health-care providers and informal medical practitioners. We have a very unique health system with a large public health system and a blanket of juxtaposed private health care system. Similar situation is also present in training and education of health workforce. There is also a lack of data on the exact number of health care providers.
Issues
Quite a percentage of Indian population is spread in the rural areas but on the other hand the concentration of health care is in the urban system. The health care providers are highly concentrated in the urban area. Health worker densities are very low in rural settings when compared with urban areas. The next issue is lack of support to the health care providers practicing in the rural area and attraction of high income, support and provisions in the urban settings for the highly specialized workforce which includes doctors, dentist etc. At the national level, the aggregate density of doctors, nurses and midwives was 2.08 per 1000 population, which was lower than WHO’s critical shortage threshold of 2.28 .
Conclusion
In a concluding remark the production of health workforce has increased too many folds which has cost increased privatization of health education. On the other hand the public medical education system has not expanded at the required level. There is need to tap the potential in the private players with keep in mind stringent control of quality and cost. The increase in production is not going to resolve the issues of health worker availability and distribution. The need of the hour is to find sustainable measures to target the acute shortfall in the trained health workforce in India.
*Health Insurance in India and Genesis of the Ayushman Bharat PMJAY Pradhan Mantri Jan Arogya Yojana
*Critical review of the health insurance schemes
*SWOCh analysis of Ayushman Bharat PMJAY
Created - July 2019
Author- Dr. Madhushree Acharya, Academic Junior Resident, Community & Family Medicine, AIIMS Bhubaneswar
Launched as recommended by the national health policy 2017
To achieve the vision of universal health coverage (UHC).
This initiative has been designed to meet Sustainable Development Goals (SDGs) and its underlining commitment, which is to "leave no one behind.“
Ayushman bharat what an why ..we must know this programme it is important for all doctors and nurses and others...very important for MBBS students also
A new group of healthcare professionals who are not doctors are called community health officers CHOs . As a part of Comprehensive Primary Health Care, CHOs will be vital in providing an increased range of essential services. They are expected to direct the primary care staff at the Sub Centre, Health and Wellness Center, offer ambulatory care and clinical management to the neighborhood, and act as a crucial coordination link to guarantee the continuum of car. Mr. Saneesh CM | Dr. S. Victor Devasirvadam "Community Health Officer (CHO): An Overview" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-7 | Issue-1 , February 2023, URL: https://www.ijtsrd.com/papers/ijtsrd53840.pdf Paper URL: https://www.ijtsrd.com/medicine/nursing/53840/community-health-officer-cho-an-overview/mr-saneesh-cm
Health workforce Statistics: Current Needs and Requirements
Introduction
Trained healthcare workforce is an important determinant of efficiency and outcomes of any health system as devised by WHO health systems approach. India one of the most populous country of the world has always felt a dire need of healthcare workforce even having one of the largest medical education and capacity building system. On the other hand we have a variety of health cadre namely from an ASHA to super specialized doctors. In our presentation we have critically analyzed the distribution of health workforce in India and its impacts on health and healthcare delivery for the mass of our society.
The Health Workforce in Nutshell
India faces an acute shortage of trained health workforce. India has a large basket of interventions to improve the healthcare but they are adversely effected by shortage of trained, motivated and supported health workforce. The shortages and misdistribution of health workforce have a large contribution to inequities in health outcomes. India’s health workforce is a combination of both registered, formal health-care providers and informal medical practitioners. We have a very unique health system with a large public health system and a blanket of juxtaposed private health care system. Similar situation is also present in training and education of health workforce. There is also a lack of data on the exact number of health care providers.
Issues
Quite a percentage of Indian population is spread in the rural areas but on the other hand the concentration of health care is in the urban system. The health care providers are highly concentrated in the urban area. Health worker densities are very low in rural settings when compared with urban areas. The next issue is lack of support to the health care providers practicing in the rural area and attraction of high income, support and provisions in the urban settings for the highly specialized workforce which includes doctors, dentist etc. At the national level, the aggregate density of doctors, nurses and midwives was 2.08 per 1000 population, which was lower than WHO’s critical shortage threshold of 2.28 .
Conclusion
In a concluding remark the production of health workforce has increased too many folds which has cost increased privatization of health education. On the other hand the public medical education system has not expanded at the required level. There is need to tap the potential in the private players with keep in mind stringent control of quality and cost. The increase in production is not going to resolve the issues of health worker availability and distribution. The need of the hour is to find sustainable measures to target the acute shortfall in the trained health workforce in India.
*Health Insurance in India and Genesis of the Ayushman Bharat PMJAY Pradhan Mantri Jan Arogya Yojana
*Critical review of the health insurance schemes
*SWOCh analysis of Ayushman Bharat PMJAY
Created - July 2019
Author- Dr. Madhushree Acharya, Academic Junior Resident, Community & Family Medicine, AIIMS Bhubaneswar
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
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Having undertaken this course in the “Policy and Practice Track” I intend the presentation to be of value to policy makers and ground level stakeholders in the healthcare sector. The main purpose of the presentation was to provide the major challenges and opportunities for Healthcare PPPs in the Indian context. I envisage it to be of help for government agencies as well as private healthcare players. It would also be helpful to researchers and NGOs who are working in the healthcare sector. The presentation dives deep into the different PPP models and highlights some of the success stories under each model. It also touches upon certain key risks and drivers of success under challenging circumstances.
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CLASS 11 CBSE B.St Project AIDS TO TRADE - INSURANCE
RSBY ((Rashtriya Swasthya Bima Yojna)
1. Birla Institute of Management Technology
Insurance Business Management
(Health Insurance)
A report on
RSBY
(Rashtriya Swasthya Bima Yojna)
Mentor: Prof. Abhijeet chattoraj
By
PRATHAM SHARMA
17IN638
2. Acknowledgement
I would like to thank Prof. Abhijeet chattoraj for taking the time out from their
busy schedule to personally help us with the work and providing insights on Health
Insurance. Their words have left an indelible mark on us and we are extremely
grateful to them for everything.
Finally, I would like to thank BIMTECH for giving us this eye opening
opportunity. There would have been very few opportunities for us to work in such
close contact with an expert from industry of Insurance.
3. Rashtriya Swasthya Bima Yojna
Current Status of RSBY Implementation in India
▪ Cards issued – App. 27.6
Million
▪ People enrolled – App. 100
million
▪ Number of People
benefitted till now –
App. 3.2 million
▪ Number of Hospitals
Empanelled
– App. 8600
▪ States where Service
delivery has started –
Twenty Five
▪ Number of Insurance
Companies Involved –
Thirteen
4. What is RSBY
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 workers, covering:
1. Building and other construction workers registered with the Welfare Boards
2. Licensed Railway Porters
3. Street Vendors
4. MNREGA workers who have worked for more than 15 days during the
preceding financial year
5. Beedi Workers
6. Domestic Workers
7. Sanitation Workers
8. Mine Workers
9. Rickshaw pullers
10. Rag pickers
11. Auto/Taxi Driver
The premium cost for enrolled beneficiaries under the scheme is shared by
Government of India and the State Governments. The program has the target to
cover 70 million households by the end of the Twelfth Five Year Plan (2012-17).
Its main service delivery model remained as demand financing, freedom of choice
among accredited government and private hospitals, and cashless service
reimbursable to provider on a pre-determined package rates on family floater basis,
could become a strong pillar for the universal health care system laid down by
Government of India.
5. 06.03.12
06.03.12
Objective of RSBY:-
RSBY has two fold objectives:
1.To provide financial protection against catastrophic health costs by reducing out
2.To improve access to quality health care for below poverty line households of
pocket expenditure for hospitalization and other vulnerable groups in the
unorganized sector
Smart Card
▪
Smart Card with embedded chip which stores details:
▪ Fingerprint and photos (up to five members)
▪ Other details like Name, Age, Gender, Relationship etc. of up to five family
members
7. Features of scheme
Empowering the beneficiary – RSBY provides the participating BPL household
with freedom of choice between public and private hospitals and makes him a
potential client worth attracting on account of the significant revenues that
hospitals stand to earn through the scheme.
Business Model for all Stakeholders – The scheme has been designed as a
business model for a social sector scheme with incentives built for each
stakeholder. This business model design is conducive both in terms of expansion
of the scheme as well as for its long run sustainability.
• Insurers – The insurer is paid premium for each household enrolled for RSBY.
Therefore, the insurer has the motivation to enroll as many households as
possible from the BPL list. This will result in better coverage of targeted
beneficiaries.
• Hospitals – A hospital has the incentive to provide treatment to large number of
beneficiaries as it is paid per beneficiary treated. Even public hospitals have the
incentive to treat beneficiaries under RSBY as the money from the insurer will
flow directly to the concerned public hospital which they can use for their own
purposes. Insurers, in contrast, will monitor participating hospitals in order to
prevent unnecessary procedures or fraud resulting in excessive claims.
• Intermediaries – The inclusion of intermediaries such as NGOs and MFIs
which have a greater stake in assisting BPL households. The intermediaries will
be paid for the services they render in reaching out to the beneficiaries.
• Government – By paying only a maximum sum up to Rs. 750/- per family per
year, the Government is able to provide access to quality health care to the
below poverty line population. It will also lead to a healthy competition
between public and private providers which in turn will improve the functioning
of the public health care providers.
Information Technology (IT) Intensive – For the first time IT applications are
being used for social sector scheme on such a large scale. Every beneficiary family
is issued a biometric enabled smart card containing their fingerprints and
photographs. All the hospitals empanelled under RSBY are IT enabled and
connected to the server at the district level. This will ensure a smooth data flow
regarding service utilization periodically.
8. Safe and foolproof – The use of biometric enabled smart card and a key
management system makes this scheme safe and foolproof. The key management
system of RSBY ensures that the card reaches the correct beneficiary and there
remains accountability in terms of issuance of the smart card and its usage. The
biometric enabled smart card ensures that only the real beneficiary can use the
smart card.
Portability – The key feature of RSBY is that a beneficiary who has been enrolled
in a particular district will be able to use his/ her smart card in any RSBY
empanelled hospital across India. This makes the scheme truly unique and
beneficial to the poor families that migrate from one place to the other. Cards can
also be split for migrant workers to carry a share of the coverage with them
separately.
Cash less and Paperless transactions – A beneficiary of RSBY gets cashless
benefit in any of the empanelled hospitals. He/ she only needs to carry his/ her
smart card and provide verification through his/ her finger print. For participating
providers, it is a paperless scheme as they do not need to send all the papers
related to treatment to the insurer. They send online claims to the insurer and get
paid electronically.
Robust Monitoring and Evaluation – RSBY is evolving a robust monitoring and
evaluation system. An elaborate backend data management system is being put in
place which can track any transaction across India and provide periodic analytical
reports. The basic information gathered by government and reported publicly
should allow for mid-course improvements in the scheme. It may also contribute
to competition during subsequent tender processes with the insurers by
disseminating the data and reports.
11. Info Graphics Of Process Flow Proposed For Streamlining The RSBY Process In Hospitals
12. Role of Health Department
✓ Install necessary hardware and software in thepublic hospitals
✓ Provide help desk in the hospital along with person
✓ Training of Hospital Personnel
✓ Provide cashless treatment on package rates
✓ Get the Reimbursement from the Insurer
✓ Organize Health Camps
✓ Enable RKS to receive money from Insurer and use it in a flexible way
✓ Tie up with Pharmacies and Diagnostic Centers
✓ Provide for cash incentives for staff
BEFORE AFTER
13. Role of Insurance Company
✓ Finalize the TPA/ Smart Card service provider
✓ Set up team at State and District level for the implementation
✓ Organize District-level workshops with all stakeholders
✓ Organize separate District workshop with health care providers before the empanelment
14. Role of Insurance Company
✓ Prepare village wise plan
✓ Communicating this plan to the villages
✓ Identify locations in each village for enrollment
✓ Coordinate with State Government for the FKOs
✓ Visit villages according to the plan with enrollment team
✓ Personalize the smart card and print and give on the spot and take Rs. 30 from the
beneficiaries.
Send consolidated data the
Government
Send Back end data to
Central Govt.
Post Enrollment
15. Suggestions pertaining to beneficiaries:
Given below are few suggestions based on the
beneficiary interaction
✓ Digitalization of the entire process to minimize paper works.
✓ If process of medicine procurement can be made directly between the pharmacy and
the hospital/department, load on patients can be reduced.
✓ Hospital administration should take necessary steps to have display of list of
empanelled pharmacy and labs. And in case the service is not available at these
authorized centers, the procedure to be followed should be listed.
✓ Point 2 & 3 are caused due to internal hospital administration problems and hospitals
should strictly follow the guidelines set under RSBY to resolve such issues.
✓ Need more awareness program about the benefits and process to be followed at the
grass route level.
✓ Treat every beneficiary as a customer and set customer satisfaction as highest priority
of RSBY to expand its reach.
Conclusion
It is thus clear from the study that majority of the beneficiaries were happy with
the service with the services provided through RSBY. This scheme helps the poor
to reduce their hospitalization expenses. Even though RSBY- has played a major
role in reducing the hospitalization expenditure among the beneficiaries, there are
a few evident problems that needs to be addressed to make the scheme more
effective and satisfactory. This scheme is moving in right direction to attain the
desired objectives of RSBY, but the policy makers should focus on identifying
and addressing the gaps to make RSBY more effective and efficient, enhancing its
coverage to a wide spectrum of the needy and the deserved.