For the majority of Indians, seeking care for serious illness can result in financial catastrophe. In response to this reality and its effect on its citizens, the government of Andhra Pradesh developed the Rajiv Aarogyasri Scheme to improve access to low frequency, high cost specialist care for its roughly seventy million residents living below the poverty line.
The state insurance program was launched in 2007. This innovative, government funded, statewide financing program created a network of providers to offer free treatment for serious and life threatening illnesses by contracting both public and private specialty tertiary care facilities. Aarogyasri has since been renamed the Dr. NTR Vaidya Seva Scheme and become one of the largest single health insurance programs in India. Many states use the program as a model to guide their own financing reforms.
ACCESS Health India conducted a study to evaluate the impact of the Aarogyasri program by examining where people access care, how often they seek care, and how much they spend on healthcare. In a survey of nearly nineteen thousand households, we compared the use of healthcare among households in Andhra Pradesh with that among households in neighboring Maharashtra, which, at the time of the survey, did not have access to similar insurance. We also compared this data with healthcare statistics, which were collected in these states before the implementation of Aarogyasri.
We found that in comparison to Maharashtra, the state of Andhra Pradesh has had three significant outcomes: an increase in hospital admission for surgeries, a decrease in out of pocket expenses for hospital care, and a reduction in the average duration of hospital stay.
The results of our study have been published in BMJ and Health Policy and Planning. The data from this study is available here. We are now updating and expanding the narrative into a book that combines a population perspective with managerial insights on the political economy of health reforms, the challenges of scale and sustainability, and the opportunity to use health insurance as a platform for quality improvement.
Our partners for this project included the Administrative Staff College of India, the Government of Andhra Pradesh, IMRB International, the Indian School of Business, the University of East London, and the World Bank.
Report: An Efficient Model for Improved Access to Quality Healthcare Services and Reduced Catastrophic Healthcare Expenditure? An Evaluation of the Rajiv Aarogyasri Health Insurance Scheme
Journal Article: Changes in Addressing Inequalities in Access to Hospital Care in Andhra Pradesh and Maharashtra States of India: A Difference in Differences Study Using Repeated Cross Sectional Surveys
Report: Innovative Health Insurance in Andhra Pradesh— Has It Worked as Planned?
Journal Article: Private Sector Participation in Delivering Tertiary Healthcare: A Dichotomy of Access and Affordability Across Two Indian States
Journal Article: Using the Indian National Sample Survey Data in Public Health Research
Report: What a Difference a State Makes: Health Reform in Andhra Pradesh