The Karnataka government’s flagship Yeshasvini health scheme is set to undergo significant reforms, with a committee of experts recommending a substantial revision in procedure rates—up to 50% for select high-end treatments. This landmark recommendation, aimed at enhancing healthcare access and encouraging wider participation from private hospitals, was recently submitted to Siddaramaiah, Chief Minister of Karnataka. 

Launched in 2003, the Yeshasvini Health Insurance Scheme has historically played a vital role in delivering low-cost, quality healthcare to millions of rural and urban cooperative members across Karnataka. Following its temporary merger with Arogya Karnataka in 2018, the scheme was revived in 2022-2023 in response to sustained demand from the farming and cooperative community.

Comprehensive Rate Rationalisation

Over the last six months, the expert committee, chaired by ophthalmologist and Kudligi MLA, Dr. Srinivas N.T., conducted an extensive review of 2,128 medical procedures, drawing insights from leading doctors and healthcare stakeholders. The panel has suggested an across-the-board rate hike of 15% to 25% for most procedures, with a 50% surge proposed for highly complex treatments including paediatric heart surgeries, oncology, neurosurgery, and interventional radiology.

“We studied the current market rates in the last six months, involving several top doctors and industry leaders. We met 13 times and have recommended the rationalisation of the existing 2,128 procedures. While six outdated procedures have been dropped, 69 new procedures have been added under the same codes. With this, the total number of medical procedures covered under the scheme now stands at 2,191,” said Dr. Srinivas N.T, MLA from Kudligi assembly constituency.

Increasing Private Hospital Participation

One of the scheme’s ongoing challenges has been limited private sector engagement due to outdated pricing structures. 

“The existing rates fixed in 2017-2018 were too low for several procedures, and many private hospitals were hesitant to get empanelled, as of now, we have 782 empanelled hospitals, but we are hoping, with the proposed revision, more hospitals will agree to treat patients under the scheme,” added Dr. Srinivas N.T. 

With about 45.6 lakh cooperative members enrolled under the Yeshasvini scheme as of March 2025, the financial implications of the revised rates are significant. Under the current model, rural families pay just ₹500 annually (₹100 for each additional member) to access cashless treatments up to ₹5 lakh per year. Urban counterparts contribute ₹1,000 per family and ₹200 per additional member for similar benefits.

Financial Impact & Future Outlook

During the 2024-2025 fiscal year, 68,159 beneficiaries were treated under the scheme, at a total expenditure of ₹117.79 crore. Projections suggest that over 75,000 beneficiaries may utilise the scheme this year, raising the anticipated cost to ₹127.5 crore. With the expansion of covered procedures and recommended rate hikes, the committee has urged the government to allocate an additional ₹40 crore to ensure seamless implementation.

“This rate revision is not just about better compensation but about improving access and quality of care for rural populations, it also represents a broader push to align public insurance with realistic cost structures and attract more hospitals to join the network,” as expressed by department health officials. 

Also Read: Akums and Tamil Nadu Agricultural University Forge Strategic Partnership to Pioneer Sustainable Pharma Innovation

A Bold Step Towards Equitable Healthcare

As one of India’s earliest self-funded rural healthcare schemes, Yeshasvini has consistently served as a model for cooperative health coverage. The new rate rationalisation plan seeks to fortify that legacy by ensuring both fiscal sustainability and improved treatment quality. Healthcare leaders across Karnataka are watching closely, as this revamp could set a precedent for similar public-private health insurance models nationwide. The government is expected to review and decide on the proposed changes in the coming weeks.

Like

Dislike

Be a part of Elets Collaborative Initiatives. Join Us for Upcoming Events and explore business opportunities. Like us on Facebook , connect with us on LinkedIn and follow us on Twitter , Instagram.

"Exciting news! Elets technomedia is now on WhatsApp Channels Subscribe today by clicking the link and stay updated with the latest insights!" Click here!