Research Questions
- How does participation in a health insurance scheme affect the quality of care received by households?
- How can incentive or payment mechanisms for the provider affect the quality of care?
- Does insurance exacerbate or alleviate moral hazard concerns related to the provider? Does insurance help ensure that the correct treatment is administered at the correct price or does it lead to overuse by both clients and providers?
- What specific features of insurance policies affect service delivery?
- What business partnerships and models can be designed to effectively address quality of care issues?
- Do households know or care about quality dimensions of insurance policies such as provider certification, preventive clinics? How do these features affect take-up and use?
- Do clients prefer open choice of providers and thus no quality control or restricted choice with options for quality control?
- Do institutional models (partner-agent, mutual) differ in their use of the highlighted features?
- What are the cost implications of including these features from the insurer’s and provider’s perspectives?
Partner organizations
Formed in 2004, Uplift India Association is an association of organizations working in microfinance, microinsurance, and family development in urban and rural areas of India.
The Micro Insurance Academy (MIA) is an Indian (Delhi-based) Charitable Trust dedicated to training, research, and advisory services for microinsurance units serving the poor. MIA will support BAIF, NIDAN, and Shramik Bharti in their implementation of community-based health insurance schemes. Additionally, MIA is carrying out the impact evaluation of these schemes.
Product
As of October 2009, this health insurance product covered 84,672 lives. Issued to a household, this policy costs Rs. 100 per year and provides for reimbursement of health care expenses up to Rs. 15,000 a year;
concession in hospital cost and medicine bills; a 24-hour helpline; and
regular health check ups and health talks.
Evaluation design
Quantitative summaries of information collected through surveys and checklists; content analysis of information collected through key informant interviews.
Data sources:
- Key informant interviews: with patients, service providers, and nongovernmental organization personnel
- Surveys: patient satisfaction survey, hospital infrastructure checklist, and patient file checklist
Sample size: 54 clients (29 insured, 25 non-insured)
Project website(s)
http://financialaccess.org/node/1842
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