Evaluation of Yeshasvini Cooperative Health Care Scheme in Karnataka for the period 2010-11 to 2014-15.
The study was funded by the Karnataka Evaluation Authority (KEA). The objectives of the present evaluation are as follows.
- To analyse the enrollment process of cooperative members in YCHCS?
- To examine the trend in number of claims and revenue of network hospitals.
- To study the average number of claims OPD and surgeries per 1000 members
- To assess the perceptions/experience of beneficiaries of YCHCS.
- To ascertain the process of pre-authorization, claim submission and approval
- To explore necessity and feasibility of merging YCHCS with other health insurance schemes in the state
Interviews were conducted with 1200 beneficiaries of surgical interventions and 300 OPD attendees. Observation visits were made to 300 empanelled hospitals and interviews conducted with the officials of cooperatives and others. All stakeholders opined that the Scheme is useful and recommended should be continued.
