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Generating and Using Cost Evidence to Inform Provider Payment Rates: Lessons from High-Income Countries for India s National Health Insurance Program | Center For Global Development

PM-JAY, India’s national health insurance program, is the largest publicly funded health insurance program in the world. It has reformed the way in which the poor and vulnerable access hospital care in India. The size of this program and the inclusion of private providers in delivering care has led to the implementation of a provider case-based payments scheme. Case-based payments are widely used throughout the world as a means of paying both individual and institutional health care providers in a manner that incentivizes efficiency relative to fee-for-service payment or traditional indemnity insurance payment.

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