Guide on the defragmentation of publicly subsidized health insurance schemes

This guidebook builds on an initial ‘Review of defragmentation of PSHI schemes’ undertaken. The guidebook provides recommendations on issues to be considered in the defragmentation and/or evaluation process as well as the processes that can inform defragmentation efforts. This guide builds on the experience drawn globally and from some states in India that have undergone such reforms. This guidebook is based on Parts 1 and 2 of the previous report which consisted of a ‘Review of Defragmentation Efforts in India and Beyond’ and ‘Conceptual Framework and Typology for Defragmentation Reforms’, respectively. In this guide, we provide information on evidence required, the human resource input and the skill sets needed to support reform efforts. The guide also includes some case studies highlighting how the thematic area is addressed practically and the results of this process. It highlights some of the key determinants of success or failure of reforms in the four Indian settings reviewed (Assam, Chhattisgarh, Kerala and Rajasthan).