Impact Insurance Research Paper #42: Evaluation of RSBY's key performance indicators

Rashtriya Swasthya Bima Yojna (RSBY) is a programme that needs no introduction. Launched in 2008 to provide secondary care to below poverty line (BPL) households, the scheme has expanded rapidly. Today, it covers nearly 38 million households and is present in 512 districts (out of a total 640) across all 28 states and union territories. This paper analyses key performance indicators (KPIs) for the programme, so as to identify ways of improving the scheme’s performance. The study focuses on three KPIs: 1) Enrolment ratio, measuring the percentage of eligible households enrolled, so as to estimate outreach; 2) Hospitalization ratio, to estimate utilisation; 3) Claims ratio, one of the key metrics that determines whether the scheme is profitable for the insurers.