International consortium to examine implementation process and impact ofIndia’s new health insurance scheme –PradhanMantri JanArogyaYojanaAbhiyan(PMJAY)Bonn/London/Delhi, 15 April 2019. The Deutsche Gesellschaft für InternationaleZusammenarbeitGmbH (GIZ), onbehalf of theGermanFederalMinistry forEconomicCooperationandDevelopment(BMZ),hastaskedaninternationalresearchconsortiumwithdocumentingimplementationprocessesandassessingtheshort-termimpactoftheIndia government’s ambitious countrywide health insurance scheme, PradhanMantriJan Arogya Yojana Abhiyan (PMJAY) – colloquially also known as “ModiCare”. Theconsortium,which is ledbyHeidelbergInstituteofGlobalHealth(FacultyofMedicine,HeidelbergUniversity)includestheGermanDevelopmentInstitute/DeutschesInstitutfür Entwicklungspolitik (DIE), City, University of London, IQVIA (India) and Nielsen(India).

PMJAYwasofficiallylaunchedonSeptember23rd,2018.Itisexpectedtobecomeoneofthe largest insurance efforts ever implemented in the world, offering coverage forsecondary and tertiary care to 500 million households. To date, PMJAY has beenadoptedby29outof32Statesand7UnionTerritories in India,often implemented inconjunctionwithexistingState insuranceschemestoensurebroaderpopulationreachand service coverage. This scheme guarantees eligible households cashless access toinpatient services delivered by either private or public empanelled hospitals up to aceilingof500,000rupeesperyear(EUROequivalent).Indiaalreadyintroducedapublichealth insurancescheme, theRashtriyaSwasthyaBimaYojana (RSBY), in2008.About41millionhouseholdswereinsuredunderthisscheme.Akeyfeature,incomparisontothe RSBY, is the absence of a family limit, meaning that all members of eligiblehouseholdaregrantedinsurancecoverageunderPMJAY. Planned research activities stretch over four distinguished, yet highly intertwinedcomponents:1)asystematicscopingreviewofsocialhealthinsuranceschemesinSouthAsia,withspecificfocusonIndia;2)aprocessdocumentation,describingthesequenceofeventsthatledtotheschemelaunchandearlyexperienceswithitsimplementation;3)ahouseholdassessment,estimatingthe impactof theschemeonhealthserviceuseandout-of-pocket expenditure;4) a hospital assessment, estimating the impact of theschemeonhealthserviceprovision.Thelattertwocomponentswillrelyrespectivelyonasampleof16,000householdsand168hospitalsdistributedinsevenStates.Theoverallevaluation relies on a mixed and multi-method approach, integrating qualitative andquantitativemethodsofdatacollectionandanalysis.

Theofficial launchoftheresearchprojecttookplaceinJanuary2019inDelhiandwashosted by GIZ. The launch workshop stretched over five days and offered theopportunity toallpartnersof the researchconsortiumtogainan insight into thenewschemeandtorefinestudyobjectivesandrelatedtools.

TheresultsoftheevaluationwillbeinstrumentalbothinshapingfurtherhealthpolicydevelopmentswithinIndiaandininformingGermandevelopmentcooperationworkinthefieldofsocialhealthprotection.

ParticipantsofthelaunchworkshopinDelhi(January2019)