Component 2

Improve design and management of the state health insurance programs

This component will support to strengthen the design, systems, and operations of the health insurance schemes in the state.

Strengthening will focus on reducing fragmentation between schemes, promoting synergy and convergence for efficiency gains, and augmenting the management capacity of the state insurance agency, thereby contributing to improved coverage and increased service utilization.

The component will support the state health insurance programs and their links with AB-PMJAY, contributing to reducing financial barriers in accessing hospital services, preventing catastrophic OOPE for health by poor families, and expanding coverage. For this, structural reforms are required for the two health insurance schemes that are running in parallel. The project will finance investments in such corrections at three levels:

(a) strengthening of policy and design for increased operational efficiency;

(b) strengthening of institutional capacity, systems, and processes of the state insurance agency for greater accountability;

(c) community interventions for improving coverage and demand, thereby increasing utilization of services as well.