Yeshasvini Health Scheme

April 24, 2025

The Yeshasvini health scheme is set for changes. A committee of experts has recommended a substantial increase in rates for medical procedures. This move aims to enhance healthcare access for rural beneficiaries in Karnataka. The report was submitted to Chief Minister Siddaramaiah and proposes revisions of up to 50% for complex procedures.

Background

Launched in 2003, the Yeshasvini scheme is a health insurance program started by the Karnataka government. It gives medical care to people in Karnataka who have a low or middle income. In 2018, this cooperative medical insurance scheme merged with other health schemes under Arogya Karnataka to streamline operations. However, due to demands from stakeholders, it was relaunched in 2022-2023.

Recent Recommendations

An expert committee conducted a thorough market analysis over six months. They reviewed rates for 2,128 medical procedures. The committee suggested a standard rate increase of 15% to 25%. However, for complex procedures like paediatric heart surgeries and oncology, a 50% increase was proposed. Six outdated procedures were removed, and 69 new ones were added.

Financial Implications

The proposed changes could impact healthcare funding. The scheme allows rural beneficiaries to access cashless treatment up to ₹5 lakh annually for a minimal contribution. Urban beneficiaries have similar coverage but at higher fees. The committee estimates that over 75,000 beneficiaries will utilise the scheme this financial year, costing approximately ₹127.5 crore.

Current Enrollment and Hospital Participation

As of March 2025, about 45.6 lakh members have enrolled in the Yeshasvini scheme. Despite the existing low rates set in 2017-2018, only 782 hospitals are currently empanelled. The hope is that the proposed rate revisions will encourage more hospitals to participate in the scheme.

Future Prospects

The committee has urged the government to allocate an additional ₹40 crore to support the scheme. This funding would help accommodate the increased treatment costs and the addition of new procedures. The focus remains on improving healthcare access for rural populations and ensuring that more hospitals join the initiative.

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