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All Journal Indian Journal of Forensic Medicine & Toxicology
Rajesh Kamath
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Public Health

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The Economic Impact of Government Sponsored Health Insurance Schemes on a Tertiary Care Multispeciality Hospital in South India Sri Theja Karra; Rajesh Kamath; Charan Tej Koyi; Renu Mirchandani; Kamath Madhusudana; Biju Soman
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 1 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i1.17427

Abstract

The number of people registered with health insurance schemes has increased from 161.2 million(2011-12) to 335 million(2016-17), which is two-fold in just 5 years.1 As per the forecasts regarding the increase in healthcare insurance market in India, it is evident that the hospitals have to face the management of patient costs through the insurance schemes in large numbers as the number of claims will increase eventually. With the present condition of schemes reimbursing the claims with a huge time lag of about 3-4 months, the hospital have to carry the burden of opportunity costs lost on these claims.2 This indicates the responsibility hospital administration should have to face the ever increasing claims and manage them without incurring loss. This study was intended to do a cost analysis between surgical procedures performed under two categories, Aarogyasri Health Insurance Scheme, A Government Sponsored Health Insurance Scheme in the state of Andhra Pradesh and Cash category, where patients do not hold any insurance policy and pay by cash all the hospital expenses. On the basis of revenue generated the top 15 procedures under Insurance scheme are determined and costing is done using Activity Based Micro Costing method. Costing is done for the determined 15 procedures under both the categories of payment modes. The results are compared to evaluate the economic impact of the health insurance scheme on hospital.
Co-Authors Biju Soman Charan Tej Koyi Kamath Madhusudana Renu Mirchandani Sri Theja Karra