Odisha CM Naveen Patnaik announced the health scheme under which 9.6 million families in the state will get two chip-based cards carrying the beneficiary’s name and a 12-digit unique registration number. (Arabinda Mahapatra/HT Photo)
Announcing the relaunch on the 75th Independence Day, Patnaik said 35 million people in the state’s 9.6 million families will be provided smart health cards under the scheme that aims to transform the health service delivery system.
“People of Odisha are my family. The news of people selling land, jewellery or taking children out of school to manage [illness] treatment costs pains me. Therefore I decided that this type of distress must go. People should get hassle-free quality treatment at best available healthcare facilities. So, Biju Swasthya Kalyan Yojana was redesigned to provide Smart Health Cards that will double up as debit cards for withdrawal of a certain amount. The move will usher in a new era in the state’s health sector,” said Patnaik.
9.6 million families in the state will get two chip-based cards carrying the beneficiary’s name and a 12-digit unique registration number. The cards will be distributed first in Malkangiri, Balangir, Sundargarh, Mayurbhanj and Gajapati districts before covering the remaining 26 districts by November.
As per the first component of BSKY, the entire population of the state is being provided free treatment in government hospitals in the state. The second component will extend cashless health coverage to smartcard holders in more than 200 empanelled hospitals in the country. No document will be required for cashless healthcare services in government hospitals. However, the beneficiaries will have to produce the smartcard or food security card at the empanelled private hospitals for availing cashless care up to the limit.
Odisha started the scheme in August 2018 to lessen the out of pocket (OOP) expenses which were very high as per the national health accounts estimate for 2016-17, released by the Union health ministry. It revealed that OOP expenditure made up 76% of the total health expenditure in Odisha and around 70% of OOP expenditure was on drugs and diagnostics services. The scheme allowed convergence of erstwhile Rastriya Swasthya Bima Yojana, Biju Krushak Kalyan Yojana and Odisha State Treatment Fund without any
premium contribution by the beneficiary or insurance intermediary.
While all government hospitals provide free services under BSKY, the scheme has also empanelled 197 private hospitals across 30 districts, which were previously empanelled with various schemes like Rashtriya Swasthya Bima Yojana (RSBY), Biju Krushak Kalyan Yojana (BKKY) or Odisha State Treatment Fund (OSTF). The state government has also empanelled some top hospitals out of the state.
An analysis of the scheme between February 2019 and February 2020, done by researchers Sudha Chandrashekar, Dhananjay, Sarit Kumar Rout, Upasona Ghosh, Vivek Panwar and N Devadasan revealed that the scheme received 17,010 pre-authorization requests, of which 97.7% were approved. Secondary level hospitalisations were a major part of the claims. The most sought after speciality treatment in private empanelled hospitals was in ophthalmology 35.58 % and general surgery 22.42% departments and the most common procedure within the specialties was cataract, haemodialysis, deliveries, hysterectomy and fissurectomy.
The average number of claims made per month under the scheme is 3,425 and the average length of hospitalisation was 1.62 days with an average claim size of ₹7,396.