Impact Evaluation of India’s ‘Yeshasvini’ Community-Based Health Insurance Programme

• What is the impact of health insurance on health care utilisation?
• What is the impact of health insurance on financial protection?
• What is the impact of health insurance on treatment outcomes and economic well-being?

Partner organizations

Yeshasvini Co-operative Farmers Health Care Scheme (YCFHCS) is a quasi-state government run health scheme for cooperative farmers in Karnataka, India.

Product

On a voluntary basis, the plan is open to all members of a cooperative society in the state of Karnataka for at least six months. Members may choose to enroll their spouse and children. There is no minimum age requirement for coverage; however, the maximum age requirement is 75.

For 2009-2010, the annual premium is Rs. 140/- (USD $3) with an additional Rs. 10/- (USD $0.22) service charge that the cooperative societies may choose to levy. Benefits include up to Rs. 2,00,000/- (USD $4,321) a year for defined surgical procedures, medical emergencies, maternity, and neonatal care. Additionally, the plan provides free outpatient care at participating hospitals.

Evaluation design

Quasi-experimental: propensity score matching between programme participants (treatment group) and non-programme participants (comparison group).

The researchers households further categorized the treatment group into

• households which had member status at the time of the survey
• households which had renewed their membership for the past three years or more, and
• households which had membership at least once in the previous four years.

The researchers further divided the comparison group into cooperative households and non-cooperative households.

Data sources:

• Surveys: household survey of 4,109 households; village survey of 82 villages
• Administrative data: information from the Karnataka Rural Development and Panchayat Raj Department and other state government departments