Success-Stories-on-Health-Sector

guJarat
muKHYamantri amrutum “ma” YoJana
ProblEm statEmEnt
Due to high burden of out of pocket expenditures,
households below the poverty line are not able
to access healthcare and are also at high risk of facing
catastrophic payments when they seek healthcare.
ProgrammE DEsCriPtion
“MA” Yojana was launched in 2012 and covers all the
below poverty line households in the State. It provides
cashless treatment for 544 tertiary care procedures up
to Rs. 2 lakh per annum for five household members
on a family floater basis, inclusive of Rs. 300 towards
transportation charges. These services can be accessed
at empanelled public and empanelled private hospitals.
ASHA receives an incentive of Rs. 100 per household, if
she accompanies them to the respective Taluka kios k for
enrollment. Every household receives a unique digital
identity card called the Quick Response Coded Card. This
card is a repository of fingerprints of the beneficiaries,
clinical notes etc. The program is funded by the State
government budget and implemented through the State
Nodal Cell (SNC), supported by an Implementation
Support Agency (ISA).The claims processing, awareness
activities and empanelment of hospitals are supported by
ISA. Claims processing is through a paperless integrated
iT platform.
From 2014, under the Mukhyamantri amrutam “Ma
Vatsalya” Yojana, benefits of the programme have been
extended to women and children of all the households
(55,124 households) with yearly income less than
Rs. 1.2 lakhs.
ProgrammE outComEs
Until January 2015, approximately 22 lakh households
have been enroled and 48000 beneficiaries have received
cashless treatments.
ConClusions/lEssons lEarnt
implementation of the programme by the government
department through a private partner supporting the
claims process awareness activities, and empanelment of
hospitals is seemingly successful in leveraging strengths
of both public and private sectors.
rEFErEnCE
http://www.magujarat.com
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