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

27 Pages Posted: 20 Apr 2016

See all articles by Joseph J. Capuno

Joseph J. Capuno

University of the Philippines (Quezon City) - School of Economics

Aleli D. Kraft

University of the Philippines (Quezon City) - School of Economics

Stella Quimbo

University of the Philippines (Quezon City) - School of Economics

Jr. Carlos R. Tan

University of the Philippines (Quezon City) - School of Economics

Adam Wagstaff

World Bank - Development Research Group (DECRG)

Date Written: May 1, 2014

Abstract

A cluster randomized controlled trial was undertaken, testing two sets of interventions to encourage enrollment in the Philippines'Individual Payer Program. Of 243 municipalities, 179 were randomly assigned as intervention sites and 64 as controls. In early 2011, 2,950 families were interviewed; unenrolled Individual Payer Program-eligible families in intervention sites were given an information kit and a 50 percent premium subsidy until the end of 2011. In February 2012, the "non-compliers" had their voucher extended, were re-sent the enrollment kit, and received Short Message Service (SMS) reminders. Half were told that in the upcoming end-line interview the enumerator could help complete the enrollment form, deliver it to the insurer, and have identification cards mailed. The control and intervention sites were balanced at baseline. In the control sites, 9.9 percent (32/323) of eligible individuals had enrolled by January 2012, compared with 14.9 percent (119/801) in intervention sites. In the sub-experiment, enrollment was 3.4 percent (10/290) among eligible non-compliers and who did not receive assistance but 39.7 percent (124/312) among those who did. A premium subsidy combined with information can increase voluntary enrollment in a social health insurance program, but less than an intervention that reduces the enrollment burden; even that leaves enrollment below 50 percent.

Keywords: Health Monitoring & Evaluation, Health Systems Development & Reform, Health Economics & Finance, Housing & Human Habitats, Health Law

Suggested Citation

Capuno, Joseph J. and Kraft, Aleli D. and Quimbo, Stella and Tan, Jr. Carlos R. and Wagstaff, Adam, Effects of Interventions to Raise Voluntary Enrollment in a Social Health Insurance Scheme: A Cluster Randomized Trial (May 1, 2014). World Bank Policy Research Working Paper No. 6893. Available at SSRN: https://ssrn.com/abstract=2443163

Joseph J. Capuno (Contact Author)

University of the Philippines (Quezon City) - School of Economics

Philippines

Aleli D. Kraft

University of the Philippines (Quezon City) - School of Economics

Philippines

Stella Quimbo

University of the Philippines (Quezon City) - School of Economics

Philippines

Jr. Carlos R. Tan

University of the Philippines (Quezon City) - School of Economics

Philippines

Adam Wagstaff

World Bank - Development Research Group (DECRG) ( email )

1818 H. Street, N.W.
MSN3-311
Washington, DC 20433
United States

HOME PAGE: http://econ.worldbank.org/staff/awagstaff

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