Data Analysis and More….S(jkmewj55x5gdl13iwbvs0d20))/hci/8HCI/ppt/... · Tata AIG, 18, 3% United India Insurance, 106, 16% . 16.07.2013 Seite Page 27 Average Premium 473500 536

16.07.2013 Seite 1 www.rsby.gov.in

Rashtriya Swasthya Bima Yojana (RSBY) Data Analysis and More….

Dr. Nishant Jain 11.07.2013

16.07.2013 Seite 2 www.rsby.gov.in Page 2

Current Status of RSBY Implementation in India Cards issued – App. 35.3 million People enrolled – Appr. 1222 million Number of People benefitted till now – Appr. 5.5 million Number of Hospitals Empanelled – Appr. 11,000 States and UT where Service delivery has started – Twenty Eight Number of Insurance Companies Involved – Fifteen

RSBY Coverage

Round 1 Round 2 Round 3 Round 4 Round 5


RSBY – Current Status From a small beginning in 2008, RSBY is now one of the

largest health insurance scheme in the World Almost all the States have started the implementation of

the scheme RSBY is being recognised internationally as a

successful model for providing health insurance, especially to the unorganised sector workers

Many countries in Asia and Africa are trying to learn from RSBY and integrate these learning into their existing/ new health insurance model

Government of India is now expanding RSBY both horizontally and vertically


RSBY – Availability of Data Often data is collected in schemes not knowing what to do with that

RSBY Collects data for specific purposes The biggest strength of RSBY is that data generated in RSBY is

electronic and available for analysis This data shall be analysed on a regular basis so as to understand the

performance and implementation of the scheme Automatic dashboard can be developed based on this data


PRIMARY DATA ANALYSES

Initial trends. Initial impact.


Premium Trends in RSBY

607 600 533 527

347

509 492 451 426 518

513

412

482 550 489

0

100

200

300

400

500

600

700

Average Premiumfor Fresh Districts in

2008


2009


2010


2011


2012 (incl freshlytendered)

In IN

R

Round 1 Round 2 Round 3 Round 4 Round 5


Conversion Ratio

40.67

57.44

67.59

53.02

14.05

63.04 60.37

80.98

45.08 47.44 43.83

48.00

55.86 55.08

37.30

82.20

56.09

38.39

86.08

53.03 57.19

67.25

51.61 50.82 63.48

46.24

61.01

48.00

79.98

59.28 61.70 49.01

68.62

48.89

63.25 73.99

44.46 46.82 38.70

53.65

67.36

68.28 16.15 42.38 78.47 77.78 77.02 46.24 31.19 57.00

39.80 38.38

0.00

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00

90.00

100.00

Year 1Year 2Year 3Year 4


3.17

2.67

4.10

3.19 3.24 3.11 2.86

3.92 3.68

2.28 2.58 2.68

3.56

2.59

3.17 3.03 2.80

2.99 2.94

2.01

2.51

3.63

3.31 3.75

3.30 2.63

3.29 3.39 3.31 3.19 2.91 2.55

3.50 2.61 2.64

3.16 2.85 2.43

2.82 2.51

3.45

3.26 3.51

2.98 3.00 3.28 3.13

2.52

3.09 3.46

3.28 1.55 0.00

1.00

2.00

3.00

4.00

5.00

6.00

Aver

age

Fam

ily S

ize

Average Family Size

Year 1 Year 2 Year 3 Year 4


Hospitalisation Ratio

Access to hospitals have increased for RSBY beneficiaries

Districts which have finished two years have higher hospitalisation

There is huge variations across different States

1.90% 2.20%

5.04%

0.00%

1.00%

2.00%

3.00%

4.00%

5.00%

6.00%

Round 1completed (345

disticts)

Round 2completed (252

districts)

Round 3 (81districts)




4.38

1.20

0.08

0.92

3.63

2.26 2.79

2.02

0.92 0.93

5.21

1.59 1.54

0.77

2.90

1.72

0.69 0.95

3.13

1.40 0.77

1.29 0.68 1.97

5.36

1.96 2.38

5.12

1.28

6.59

1.78 1.10 1.66

6.05

0.84 1.36 2.36 2.11 1.59 0.98

2.78 2.622.15

6.09

7.30

0.99

1.96 2.72

1.88

3.22 1.40 0.00

1.00

2.00

3.00

4.00

5.00

6.00

7.00

8.00Hospitalisation Ratio



Average Claim Size

2928

6599

8647

4310 4986 5040 4678

3704 4156 5271

2576

4573

10633

5560 5242

8296

3840

5960

2073

5205 4447

6176

6972 5814

4122 2041

5367 4950 3781 4436

3126

5440

12047

6185 6091

11818

4668 5202 5207 5901

6723

4411

3474 5196 4469 2639 9160

5785

6619 5816

4842

4567

0

2000

4000

6000

8000

10000

12000

14000



Average Claim Size

27.02%

34.60%

11.90% 11.90% 12.18%

2.11% 0.28%

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

35.00%

40.00%

0-2500 2501-5000 5001-7500 7501-10000 10001-15000 15001-20000 20001 & above


Percentage of Claims with Average Length of Stay

38.54%

21.60%

16.42%

4.23%

12.42%

6.02%

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

35.00%

40.00%

45.00%

1 2 3 4 5 6 & above

% of Claims with Average Length of Stay


345 Districts where One Year Completed

252 Districts where Two Years Completed

Expenditure by

Insurance Company

74%

Money left for

administration cost and profit

26%

Round 1 (345 districts) Expenditu

re by Insurance Company

96%

Money left for

administration cost and …

Round 2 (252 districts)

104%

-4% -20%

0%20%40%60%80%

100%120%

Expenditure by InsuranceCompany

Money left foradministration cost and

profit

Round 3 (81 districts)


Burnout Ratio

90 72

33 48

116

83 82

102

61 56

100

62

118

48

119 98

37 56

168

80 74 64

96

56

95 82 83

117

234

74

161

87 97 75

195

72 83 94

81

97 78 126

88 80

288

99 67

91

128 119

122 62 0

50

100

150

200

250

300Burn Out Ratio



Male - Female Distribution

61% 55% 53%

39% 45% 47%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Round 1 Round 2 Round 3

Male Enrollment Female Enrollment

58% 58% 46%

42% 42% 54%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Round 1 Round 2 Round 3

Male Hospitalization Ratio Female Hospitalization Ratio

Gender Wise Enrolment Rate Gender Wise Hospitalization Ratio


Relationship Distribution

32%

18%

0% 1%

18%

12%

0% 0% 0% 0% 1% 1% 0% 0% 0% 0%

16%

0%

5%

10%

15%

20%

25%

30%

35%


Female Head of Household

14%

16%

21%

34%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Round 1 Round 2 Round 3 Round 4


Five Member Limit

Families with Less than Five members

enrolled, 82.55%

Families with Five members enrolled,

17.45%


Age Distribution

22%

18% 17%

13%

8%

3%

20%

31%

21% 19%

14% 14%

0% 1%

7%

36%

19%

17%

21%

1% 0% 0%

5%

10%

15%

20%

25%

30%

35%

40%

0-17 18-30 31-40 41-50 51-80 81-120 120+

Pre EnrollmentPost EnrollmentTransaction


Disease Distribution of Claims 29.7%

17.4%

9.0% 5.3% 5.1% 4.4% 4.1% 2.8%

2.7% 2.6% 2.5% 2.4% 2.4% 2.0% 1.7% 1.5% 1.5% 1.5% 1.3%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%


Example of Cataract - Age Distribution 0 - 17

1% 18 - 30

1% 31 - 40

3%

41 - 50 14%

51 - 80 80%

81 - 120 1%


Difference in Age in Card and Age Entered at Hospital

Age Difference % of Total 0 - 2 29.86%

3 - 5 25.79%

6 - 10 23.34%

11 - 15 10.37%

16 - 20 4.74%

21 - 25 2.04%

26 - 30 1.19%

31 - 35 0.68%

36+ 1.74%


Percentage of Inter-District Claims

% of Inter District Claims

20%

% same district claims 80%


Insurance Company Analysis


District Years Apollo Munich, 22, 3% Cholamandala

m MS, 48, 7%

ICICI Lombard, 177, 26%

IFFKO TOKIO, 8, 1%

National Insurance, 101, 15%

New India Assurance, 63, 9%

Oriental Insurance, 108, 16%

Royal Sundaram, 11,

2%

Star Health, 16, 2%

Tata AIG, 18, 3%

United India Insurance, 106, 16%


Average Premium

473

536 562

395

543 490

532 502

393

507 506

0

100

200

300

400

500

600


Conversion Ratio

54% 56% 51% 53%

57% 57%

49%

60%

50% 54% 56%

0%

10%

20%

30%

40%

50%

60%

70%


Average Family Size

2.38

3.40

2.23

2.57

3.35 3.14 3.11

3.29

2.83

3.37 3.10

0.00

0.50

1.00

1.50

2.00

2.50

3.00

3.50

4.00


Burnout Ratio

71% 78%

82%

100% 92%

96%

77% 72% 72%

58%

104%

0%

20%

40%

60%

80%

100%

120%


Road Ahead Much deeper Systematic Analysis of all this data is being

done now An Agency has been hired to dig deep into this data and

do analysis A data analysis framework is also being developed

which will guide data analysis A dashboard is being developed which will help both

Central and State Governments in analysing data at different levels

Regular reports will be published based on this data analysis


Where do we want to enter?


Impact Improvement in access to Healthcare.

Hospitals being set up in remote areas by the private sector Public Sector hospitals competing and improving

performance to gain access to flexible funds & incentives Share of claims of public hospitals increasing over time

Penetration in the areas affected by extremist activities. Marked improvement in utilization by women in scheme. For expenditures beyond Rs. 30,000, State Governments

designing own schemes Himachal Pradesh, Meghalaya, Gujarat and Kerala are already

providing Few other States are in the process of taking decision

BPL lists is improving


Impact Utilisation data from States is able to provide disease

profiling across different districts As per different evaluations Out of pocket expenditure on

health of RSBY beneficiaries has come down dramatically As per different evaluations instances of health related

debts have come down Access to health care has improved considerably for RSBY

beneficiaries Migrant workers are getting benefits across districts and

States of RSBY


RSBY Smart Card Platform RSBY Smart Card Platform is emerging a robust platform

to deliver other social security schemes also Ministry of Finance has taken a decision to use RSBY

Smart card to deliver Aam Aadmi Bima Yojana benefits to the beneficiaries

MoRD has taken a decision to use this smart card for National Social Assistance Programme

State of Chhattisgarh is delivering PDS through RSBY Smart Card

Discussions are going on to test RSBY Smart card platform for MGNREGS


Thank You [email protected]

Documents

Data Analysis and More….S(jkmewj55x5gdl13iwbvs0d20))/hci/8HCI/ppt/... · Tata AIG, 18, 3% United India Insurance, 106, 16% . 16.07.2013 Seite Page 27 Average Premium 473500 536