Effects of Interventions to Raise Voluntary Enrollment in a Social Health Insurance Scheme : A Cluster Randomized Trial

Capuno, Joseph J. ; Kraft, Aleli D. ; Quimbo, Stella ; Tan, Carlos R., Jr. ; Wagstaff, Adam

World Bank, Washington, DC

关键词: ADVERSE SELECTION;    COMMUNITIES;    COST-EFFECTIVENESS;    DEMAND FOR HEALTH;    DEMAND FOR INSURANCE;   

DOI  :  10.1596/1813-9450-6893
RP-ID  :  WPS6893

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

A cluster randomized controlled trialwas undertaken, testing two sets of interventions toencourage enrollment in the Philippines' IndividualPayer Program. Of 243 municipalities, 179 were randomlyassigned as intervention sites and 64 as controls. In early2011, 2,950 families were interviewed; unenrolled IndividualPayer Program-eligible families in intervention sites weregiven an information kit and a 50 percent premium subsidyuntil the end of 2011. In February 2012, the"non-compliers" had their voucher extended, werere-sent the enrollment kit, and received Short MessageService (SMS) reminders. Half were told that in the upcomingend-line interview the enumerator could help complete theenrollment form, deliver it to the insurer, and haveidentification cards mailed. The control and interventionsites were balanced at baseline. In the control sites, 9.9percent (32/323) of eligible individuals had enrolled byJanuary 2012, compared with 14.9 percent (119/801) inintervention sites. In the sub-experiment, enrollment was3.4 percent (10/290) among eligible non-compliers and whodid not receive assistance but 39.7 percent (124/312) amongthose who did. A premium subsidy combined with informationcan increase voluntary enrollment in a social healthinsurance program, but less than an intervention thatreduces the enrollment burden; even that leaves enrollmentbelow 50 percent.