New health financing Mechanisms

A Task Group to examine new health financing mechanisms, including Risk Pooling for Hospital Care as follows:

  • Progressively the District Health Missions to move towards paying hospitals for services by way of reimbursement, on the principle of "money follows the patient".
  • Standardisation of services - outpatient, in-patient, laboratory, surgical interventions - and costs will be done periodically by a committee of experts in each state.
  • A National Expert Group to monitor these standards and give suitable advice and guidance on protocols and cost comparisons.
  • All existing CHCs to have wage component paid on monthly basis. Other recurrent costs may be reimbursed for services rendered from District Health Fund. Over the Mission period, the CHC may move towards all costs, including wages reimbursed for services rendered.
  • A district health accounting system, and an ombudsman to be created to monitor the District Health Fund Management, and take corrective action.
  • Adequate technical managerial and accounting support to be provided to DHM in managing risk-pooling and health security.
  • Where credible Community Based Health Insurance Schemes (CBHI) exist/are launched, they will be encouraged as part of the Mission.
  • The Central government will provide subsidies to cover a part of the premiums for the poor, and monitor the schemes.
  • The IRDA will be approached to promote such CBHIs, which will be periodically evaluated for effective delivery.