CARE RURAL HEALTH MISSION HMI, DELHI

SEP 26, 201211/20/2012 1

INSURING PRIMARY CARE- A

SUSTAINABLE FINANCING SOLUTION

FOR RURAL PRIMARY HEALTH

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LOCATION MAP

Yavatmal

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LEARNING AGENDA

• Is the information technology or intervention with hand held device cost-beneficial for the sustainability of the scheme?

• Does purchasing the insurance package increase the access to health care, health outcomes, and financial risk protection of the insured participants?

• What are the likely impacts of public health interventions (in this case, the preventive and promotive interventions) on health outcomes and expenditures in the population of interest?

• Has the CARE intervention improved quality of health services to its users?

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PROJECT SCHEDULE

• June 2009 – Program Initiated

• Action Research Field study – Aug - Sep 2010

• Microinsurance Program launch – Nov 2010

• Midline Study – May 2011

• HHD technology – Pilot Launch July 2011

• Microinsurance Program 2nd year – Nov 2011

• Endline Study – Oct -Nov 2011

• HHD Scale up – Oct - Nov 2012

• Research Study – Jan 2013

• Project Closure – May 2013

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THE DELIVERY MODEL…

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Project Framework

• District – Yavatmal, Maharashtra

• Area background– Tribal , agriculture area

– Low income population

– Low literacy levels

• Health workers – 50

• Remote Doctor – 2

• Project Staff – 12

• Population coverage – 35,000

• Treatments - 20,000/ annum

• Services – Primary Care 24 X 7

• Microinsurance– Families : 1032 ( 4316 lives)

– Premium : Rs 300 ( family of 4)

– Product benefits : Consultation, drugs, Injection, IV fluids and Basic blood tests

– Claims Ratio : 172% ( till June 2012)

– Renewals Rate : 37%

– Coverage Ratio : 14.39%

– Frequency per capita : 1.41

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VILLAGE HEALTHCENTER

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PRODUCT• Out-Patient (OP) primary health care services through a hub and spoke

model with the clinic at the backend, and Village Health Champions (VHC) with hand-held devices at the front-end in the villages.

• Consulting services through healthworker and remote doctor

• Generic drugs at the village, and other drug subsidies at the clinic

• Diagnostics at the village & Clinic level, and follow up care at the clinic

• Preventive and promotive services at the village level for OP insured clients at a discounted price– Soap

– Jeevan Drop (Potchlor )

– Mosquito Oil

– Hankies

– Mask

• Value Added Services– Discounts on X-ray, USG and Hospitalization

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DEMOGRAPHICS

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KEY POINTS

• Occupation : Almost 95 percent of the families are engaged either as a daily wage labourer (71 percent)

• Of the enrolled households, 39 percent of the households have purchased one or more items included in the PP package

• The average claim per household per month (for each household that claimed at all) was Rs. 40 ($ 0.8)

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PRODUCT UTILISATION

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Frequency

INCIDENCE RATE BY AGE

No. Indicator Incidence rate

1 0-18 years 102 percent

2 19-35 years 131 percent

3 36-55 years 126 percent

4 >55 years 94 percent

TOTAL 116 percent

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DISEASE BREAK UP

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Fever&

Cough, 27%

Body Ache,

16%Others,

15%Vomiting &

Diahorrea, 9%

URTI, 7%

PP package, 5%

Injury, 5%

Gastro Entritis,

5%

Joint Pain, 4%

Malaria, 4%LRTI, 4%

HEALTHWORKER – HANDHELD DEVICE

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mHEALTH APPLICATIONS

Patient care & Micro Insurance Application

Functions

• Patient Treatments

• Clinical Decision Support

System

• Micro Insurance

• Transactions System

• Survey

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INSURANCE EDUCATION AND

ENROLLMENT

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BIOMETRIC CARD LAUNCH

HEALTHWORKER – HHD

LAUNCH

BIOMETRIC CARD LAUNCH

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WINNER OF NASSCOM EMERGE CONCLAVE 2010

Care Rural Health Mission - Confidential

Microinsurance product ImpelCARE wins NASSCOM’s AppFAME Contest

WINNER OF mBillionth SOUTH ASIA AWARD FOR

mHEALTH 2011

Care Rural Health Mission - Confidential

GROWTH MAP

Yavatmal

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East and West

Godavari

Kalahandi

Angul , Rural

Hospital

Kakinada ,

Rural Hospital

Nagai, Tamil

nadu

Korba,

Chhattisgarh

Thank You

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