Case study

Evaluation of RSBY’s Key Performance Indicators: A Biennial Study

Studying the efforts of a mass health-care insurance scheme to serve the poor
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This paper analyzes the key performance indicators (KPIs) of Rashtriya Swasthya Bima Yojna (RSBY), so as to identify ways of improving the scheme’s performance. The RSBY scheme was launched in 2008 in India to provide secondary care to below poverty line (BPL) households. The program now covers nearly 38 million households and is present in 512 districts across all 28 states and union territories in the country. This study focuses on three KPIs of the scheme: enrollment ratio to estimate outreach, hospitalization ratio to estimate utilization, and the claims ratio to estimate the profitability of insurers. The paper covers the following sections in detail:

  • Introduction to the RSBY program;
  • Methodology of the study with a focus on regression analysis;
  • Comparison of the RSBY hospitalization rates and the National Sample Survey Organization’s measured hospitalization rates to measure the impact of mass health-care insurance schemes;
  • Best practices used by some states that could improve the performance of the RSBY program;
  • Recommendations with a focus on improving quality of BPL lists and data sources, promoting greater public sector hospital autonomy, achieving greater state ownership of the RSBY program, and developing a scientific methodology to determine the health-care provider package rates.

About this Publication

By Shoree, S., Ruchismita, R. & Desai, K.
Published