ACCESS Health International advanced its multistate capacity assistance program to strengthen implementation of government sponsored health insurance programs in Kerala and Odisha, India. The partnerships are formalized with the State Health Agency (SHA) [1] and Department of Health and Family Welfare, in Kerala and the Health Systems Transformation Platform (HSTP) [2] in Odisha.
In Kerala, a southern state in India Universal Health Coverage relevant reforms have been in place for over a decade. Kerala converged many of its government sponsored health care schemes [3] with Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PMJAY) [4] and established Karunya Arogya Suraksha Padhathi (KASP) [5] as the implementing organization. The engagement in Kerala will prioritize support for convergence of health schemes, strengthening institutional functions for health insurance and facilitate collaborative learning.
Similarly, the state of Odisha introduced several reforms to make healthcare accessible, affordable, and equitable while assuring quality. The state in its pursuit to UHC has launched and implemented health insurance and other schemes to provide free healthcare to the people of the state. There is increasing focus of the state to optimize delivery and efficiency through convergence and institutional building. ACCESS Health through HSTP; partners with the state in capacity building of core insurance functions, use of information and evidence for programming and driving quality initiatives.
The new partnerships provide tremendous opportunities to support the two states towards Universal Health Coverage.
[1] State Health Agency refers to the a body set up by the Department of Health and Family Welfare, in the state for the purpose of coordinating and implementing Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)
[3] Converged schemes such as – RashtriyaSwasthya Bima Yojana (RSBY), Comprehensive Health Insurance Scheme-CHIS (Kerala government fully sponsored scheme i.e. full premium paid by the State), Senior Citizen Health Insurance Scheme-SCHIS (all the senior beneficiaries aged 60 years and above in the RSBY/CHIS families were provided additional coverage of Rs 30,000 per beneficiary) and Karunya Benevolent Fund-KBF (Trust model implemented through Lottery department)
[4] In September 2018, India launched Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), one of the largest health assurance programs in the world to achieve Universal Health Coverage (UHC). AB-PMJAY provides a health cover of INR 500,000 /family /year for secondary and tertiary care hospitalization to approximately 500 million poor and vulnerable families.
[5] Kerala converged all government sponsored health insurance programs such as Comprehensive Health Insurance Scheme (CHIS), Comprehensive Health Insurance Agency of Kerala (CHIAK) and PMJAY to form Karunya Arogya Suraksha Padhathi (KASP) and standardized implementation of health insurance programs in the state