Insurance Program Research Articles

Forecast the Building Insurance Program Based on Grey Predictions and TOPSIS

Forecast the Building Insurance Program Based on Grey Predictions and TOPSIS

A welfare analysis of Medicaid and recidivism.

We present conservative estimates for the marginal value of public funds (MVPF) associated with providing Medicaid to inmates exiting prison. The MVPF measures the ratio between a policy's social benefits and its governmental costs. Our MVPF estimates suggest that every additional $1 the government spends on providing inmates exiting prison with Medicaid coverage can result in social benefits ranging between $3.45 and $10.62. A large proportion of the benefits we consider stems from the reduced future criminal involvement among former inmates who receive Medicaid. Employing a difference-in-differences approach, we find that Medicaid expansions reduce the average number of times a released inmate is reimprisoned within 1year by approximately 11.5%. By combining this estimate with key values reported elsewhere (e.g., victimization costs, data on victimization and incarceration), we quantify specific benefits arising from the policy. These encompass diminished criminal harm due to lower reoffense rates, direct benefits to former inmates through Medicaid coverage, increased employment opportunities, and reduced loss of liberty resulting from fewer future reimprisonments. Net-costs consist of the cost of providing Medicaid net of changes in the governmental cost of imprisonment, changes in the tax revenue due to increased employment, and changes in spending on other public assistance programs. We interpret our estimates as conservative since we deliberately err on the side of under-estimating benefits and over-estimating costs when data on specific items are imprecise or incomplete. Our findings align closely with others in the sparse literature investigating the crime-related welfare impacts of Medicaid access, underscoring the substantial indirect benefits public health insurance programs can offer through crime reduction, in addition to their direct health-related advantages.

Association Between Coronary Artery Disease and Herpes Zoster: A Cohort Study in Taiwan.

Coronary artery disease (CAD) and herpes zoster represent significant health burdens, and their potential interrelationships remain understudied. This cohort study aimed to address the existing knowledge gap by systematically exploring whether people with CAD are at increased risk for developing herpes zoster. Using the 2006-2015 claims data of the National Health Insurance Program in Taiwan, we identified participants aged ≥20 years with a new diagnosis of CAD as the CAD group. We selected sex- and age-matched participants without CAD as the non-CAD group. The incidence rate of herpes zoster at the end of follow-up was calculated. A multivariable Cox proportional hazards regression model was used to measure the hazard ratio and 95% CI for herpes zoster associated with covariables. The overall incidence rate of herpes zoster was 1.14-fold greater in the CAD group as compared with the non-CAD group (6.52 vs 5.74 per 1000 person-years; 95% CI, 1.08-1.20). After controlling for covariables, the adjusted hazard ratio of herpes zoster was 1.21 (95% CI, 1.14-1.27) for the CAD group as compared with the non-CAD group. This cohort study provides valuable insights into the potential association between CAD and the risk of developing herpes zoster. The findings may have implications for preventive strategies of herpes zoster in people with CAD. Further research and collaboration with diverse groups will be critical to validate and extend our findings.

Feedback and Financial Incentives for Reducing Cell Phone Use While Driving

Handheld phone use while driving is a major factor in vehicle crashes. Scalable interventions are needed to encourage drivers not to use their phones. To test whether interventions involving social comparison feedback and/or financial incentives can reduce drivers' handheld phone use. In a randomized clinical trial, interventions were administered nationwide in the US via a mobile application in the context of a usage-based insurance program (Snapshot Mobile application). Customers were eligible to be invited to participate in the study if enrolled in the usage-based insurance program for 30 to 70 days. The study was conducted from May 13 to June 30, 2019. Analysis was completed December 22, 2023. Participants were randomly assigned to 1 of 6 trial arms for a 7-week intervention period: (1) control; (2) feedback, with weekly push notification about their handheld phone use compared with that of similar others; (3) standard incentive, with a maximum $50 award at the end of the intervention based on how their handheld phone use compared with similar others; (4) standard incentive plus feedback, combining interventions of arms 2 and 3; (5) reframed incentive plus feedback, with a maximum $7.15 award each week, framed as participant's to lose; and (6) doubled reframed incentive plus feedback, a maximum $14.29 weekly loss-framed award. Proportion of drive time engaged in handheld phone use in seconds per hour (s/h) of driving. Analyses were conducted with the intention-to-treat approach. Of 17 663 customers invited by email to participate, 2109 opted in and were randomized. A total of 2020 drivers finished the intervention period (68.0% female; median age, 30 [IQR, 25-39] years). Median baseline handheld phone use was 216 (IQR, 72-480) s/h. Relative to control, feedback and standard incentive participants did not reduce their handheld phone use. Standard incentive plus feedback participants reduced their use by -38 (95% CI, -69 to -8) s/h (P = .045); reframed incentive plus feedback participants reduced their use by -56 (95% CI, -87 to -26) s/h (P < .001); and doubled reframed incentive plus feedback participants reduced their use by -42 s/h (95% CI, -72 to -13 s/h; P = .007). The 5 active treatment arms did not differ significantly from each other. In this randomized clinical trial, providing social comparison feedback plus incentives reduced handheld phone use while individuals were driving. ClinicalTrials.gov Identifier: NCT03833219.

Dynamics of Dental Care for the Population of the Ryazan Region in COVID-19 Pandemic

INTRODUCTION: Identification of morbidity (based on requests) and the population’s need for dental care optimizes the planning and distribution of compulsory health insurance (CHI) funds between medical organizations at the regional level. However, due to a decrease in the population’s demand for medical care in the context of the new coronavirus infection (Corona Virus Disease 2019, COVID-19), the dynamics of the provision of dental care and the structure of dental morbidity taken into account in the compulsory medical insurance system, have changed. AIM: To study the structure and dynamics of the provision of dental care in the period 2018–2021 (pre-pandemic and COVID-19 pandemic period) based on the volume of dental care paid for in the compulsory medical insurance system provided to citizens of the Ryazan region (RR). MATERIALS AND METHODS: The analysis was carried out on the basis of registers of bills accepted for payment submitted by medical organizations, taking into account the results of control and expert measures. All completed cases of treatment of insured persons with dental diseases in medical organizations of the Ryazan Region for 2018–2021 were selected for study according to territorial compulsory medical insurance programs. RESULTS: In the structure of outpatient primary health care in 2021, cases of its provision in the ‘Dentistry’ profile amounted to 7.40 ± 0.10%, taking 3rd place; the total number of cases of providing medical care to patients with this pathology decreased by 5.60% compared to 2018. Despite the reduction in the volume of primary dental care, the volume of dental examinations of the population of the RR increased by 30.46%. There was also a 34.08% reduction in completed cases of treatment of chronic periodontitis (p 0.02). For the 2018–2021 period 73,049 medical and economic examinations (MEE) and 1,626 examinations of medical care quality (EMCQ) were carried out, and 1,966 violations were identified (1,316 based on the results of the MEE and 650 based on the results of the EMСQ). The vast majority of these concerned non-compliance with standards of care and clinical guidelines. CONCLUSION: The results of the study indicate a reduction in the number of cases of insured persons seeking medical care for dental diseases during the COVID-19 pandemic. Owing to the approval of Order No. 231n of the Ministry of Health of Russia of March 19, 2021, obliging medical insurance organizations to carry out control and expert measures in each medical organization in a certain amount of dental care cases accepted for payment, the number of examinations has increased, and, as a result, the identification of violations in the provision of dental care.

Transforming Lives Through Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (ABPMJAY): A Review

Background: The Pradhan Mantri Jan Arogya Yojana (PMJAY) program was created in line with the global goal of Universal Health Coverage (UHC), and aims to ensure everyone has access to quality healthcare services without suffering financial difficulties. In India, over 60% of healthcare spending is still borne by households, and a significant portion of the population lacks any form of health protection coverage. Discussion: The High-Level Expert Group (HLEG) recommended a shift from supply-side healthcare financing to demand-side financing, leading to the introduction of government-sponsored health insurance schemes. To achieve Universal Health Coverage (UHC), the Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (PMJAY) was launched following the recommendations of the National Health Policy 2017. The PMJAY program is the world's largest publicly sponsored social health insurance program, delivering comprehensive healthcare services covering primary, secondary, and tertiary care levels. The scheme covers approximately 12 crore households, including more than 50 crore beneficiaries, offering healthcare coverage of up to Rs. 5 lakh per family annually. PMJAY operates nationwide in India, covering all states and union territories except for a few.. Conclusion: To move forward, PMJAY can play a transformative role in the healthcare landscape, integrate with primary healthcare, contribute to economic development, and expand its scope to include more healthcare services.

Quality, Spending, Utilization, and Outcomes Among Dual-Eligible Medicare-Medicaid Beneficiaries in Integrated Care Programs

Most dual-eligible Medicare-Medicaid beneficiaries are enrolled in bifurcated insurance programs that pay for different components of care. Therefore, policymakers are prioritizing expansion of integrated care plans (ICPs) that manage both Medicare and Medicaid benefits and spending. To review evidence of the association between ICPs and health care spending, quality, utilization, and patient outcomes among dual-eligible beneficiaries. A search was conducted of PubMed/MEDLINE (January 1, 2010, through November 1, 2023) and Google Scholar (January 1, 2010, through October 1, 2023) and augmented with reports from US federal and state government websites. Three categories of ICPs were evaluated: Programs of All-Inclusive Care for the Elderly (PACE), Medicare-Medicaid Plans (MMPs), and Fully Integrated Dual Eligible Special Needs Plans (FIDE-SNPs) and related models aligning Medicare and Medicaid coverage. The review included studies that evaluated beneficiaries dually eligible for and enrolled in full Medicaid; compared an ICP to a nonintegrated arrangement; and evaluated utilization, spending, care coordination, patient experience, or health for 100 or more beneficiaries. In all, 26 ICP evaluations met the inclusion criteria and were included in the analysis: 5 of PACE, 13 of MMPs, and 8 of FIDE-SNPs and other aligned models. Evidence generally showed associated reductions in long-term nursing home stays in PACE (3 of 4 studies) and FIDE-SNPs and related aligned models (3 of 5 studies) but was mixed in evaluations of MMPs. Four of 9 studies of MMPs and 2 of 3 studies of FIDE-SNPs found higher outpatient use, although other studies showed no difference. Evidence on Medicaid spending was limited, whereas 8 of 10 studies of MMPs showed an association between these plans and higher Medicare spending. Evidence was mixed or inconclusive regarding care coordination and hospitalizations, and it was insufficient to evaluate patient satisfaction, health, and outcomes in beneficiary subgroups (eg, those with serious mental illness). Furthermore, studies had limited ability to control for bias from unmeasured differences between enrollees of ICPs compared with nonintegrated models. This systematic review found variability and gaps in evidence regarding ICPs and spending, quality, utilization, and outcomes. Studies found some ICPs were associated with reductions in long-term nursing home admissions, and several identified increases in outpatient care. However, MMPs were primarily associated with higher Medicare spending. Evidence for other outcomes was limited or inconclusive. Research addressing these evidence gaps is needed to guide ongoing efforts to integrate coverage and care for dual-eligible beneficiaries.

What Every Colorectal Surgeon Should Know About the Updated Medicare Access and Children's Healthcare Insurance Program Reauthorization Act and the Merit-Based Incentive Program System Legislation.

What Every Colorectal Surgeon Should Know About the Updated Medicare Access and Children's Healthcare Insurance Program Reauthorization Act and the Merit-Based Incentive Program System Legislation.

Human‐wildlife conflict at high altitude: A case from Gaurishankar conservation area, Nepal

AbstractHuman–wildlife conflict studies of high‐altitude areas are rare due to budget constraints and the challenging nature of research in these remote environments. This study investigates the prevalence and increasing trend of human–wildlife conflict (HWC) in the mountainous Gaurishankar Conservation Area (GCA) of Nepal, with a specific focus on leopard (Panthera pardus) and Himalayan black bear (Ursus thibetanus laniger). The study analyzes a decade of HWC reports and identifies goats as the livestock most targeted by leopards. The Dolakha district of GCA received the highest number of reports, highlighting the need for mitigation measures in the area. In GCA, livestock attacks accounted for 85% of compensation, with the remaining 15% for human injuries. We estimate that the number of reported wildlife attacks grew on average by 33% per year, with an additional increase of 57 reports per year following the implementation of a new compensation policy during BS 2076 (2019 AD). While bear attacks showed no significant change post‐rule alteration, leopard attack reports surged from 1 to 60 annually, indicating improved compensation may have resulted in increased leopard‐attack reporting rates. The findings emphasize the economic impact of HWC on local communities and suggest strategies such as increasing prey populations, promoting community education and awareness, enhancing alternative livelihood options, developing community‐based insurance programs, and implementing secure enclosures (corrals) to minimize conflicts and foster harmonious coexistence. This research addresses a knowledge gap in HWC in high‐altitude conservation areas like the GCA, providing valuable insights for conservation stakeholders and contributing to biodiversity conservation and the well‐being of humans and wildlife.

Kebijakan Kesehatan di Indonesia: Tinjauan, Tantangan, dan Rekomendasi

The Indonesian government has made various efforts to overcome this health problem, such as through the National Health Insurance (JKN) program which aims to provide more equitable access to health services for the entire population. This study aims to identify and analyze key health policies in Indonesia, as well as evaluate the successes and challenges in their implementation. The research method uses the literature review method to analyze, identify and analyze key health policies in Indonesia, as well as evaluate the successes and challenges in their implementation. The research method uses the literature review method to analyze, identify and analyze key health policies in Indonesia, as well as evaluate the successes and challenges in their implementation. Literature review is an effective method for collecting, analyzing, and synthesizing information from various sources relevant to the research topic. The results of the study show that the importance of health policies in Indonesia to improve public health. Through the identification of key health policies, evaluation of their successes, and challenges in their implementation, this study provides an in-depth understanding of the political dynamics that influence health policies. In conclusion, by identifying key health policies, evaluating their success, and facing challenges in their implementation, this study provides a comprehensive understanding of the political dynamics that influence health policies.

Remittance‐financed social protection programmes for international migrant workers in Latin America

AbstractIn recent years in Latin America, a small number of contributory social protection programmes have been extended on a voluntary basis to cover migrant workers, with affiliation financed by these workers’ remittances. That remittances offer a means to finance social protection programmes demonstrates the possibilities presented by international migration not only as regards improving social protection coverage but in contributing towards achieving target 1.3 of the Sustainable Development Goals 2030 Agenda. This article addresses voluntary insurance programmes introduced in Ecuador, Guatemala and Mexico for nationals working abroad and by means of which the families of such international migrant workers can also access health care and benefits in their home countries. In turn, international migrant workers on returning home can gain eligibility for a contributory retirement pension and disability benefits if they satisfy eligibility as well as the contribution conditions.

Social insurance for gig workers: Insights from a discrete choice experiment in Malaysia

AbstractThe rise of “gig” work globally has led to both enthusiasm for its potential to create lucrative employment for a large number of workers, as well as concerns about its implications for social protection. Even where social insurance systems allow for voluntary coverage, take‐up among gig workers has remained low, leaving them unprotected against a range of risks. Looking at the Malaysian labour market, this article investigates whether the low take‐up of social security coverage among gig workers can be explained by the inability or unwillingness of these workers to make the necessary social insurance contributions? We deploy a novel vignette‐based experiment to ascertain gig workers’ willingness to pay for social insurance coverage. We find a large unmet need for social insurance among gig workers, as well as a high level of willingness to pay for unemployment insurance, retirement savings, and work‐related injury insurance. Our analysis suggests that gig workers could benefit more from better tailored, more flexible, and more easily accessible instruments for social insurance, rather than from subsidies or matching contributions alone. We also find evidence of substitution between distinct insurance instruments; those gig workers with access to retirement savings are less willing to pay for unemployment insurance, and those with private medical insurance are less likely to contribute to the public work‐related injury insurance programme. This underlines the need to consider a wider range of insurance instruments for gig workers, including those offered by the private sector.

Factors Associated with Enrollment of Household in National Health Insurance Program in Eastern Nepal

Background Health insurance is entrusted to make health services more equitable and decrease the financial burden caused by catastrophic out-of-pocket payments. This study aimed to assess the factors affecting the enrollment of households in National Health Insurance Program (NHIP) in eastern Nepal.MethodsCross-sectional data were collected from 189 households in Itahari sub-metropolitan city using a structured questionnaire. Chi-square tests was used to examine the association between NHIP enrollment and selected demographic variables derived from the data.ResultsThe findings showed that 63% of households were enrolled in NHIP and enrollment was associated with education, family type, ethnicity, socio-economic status, prior experience of illness, utilization of health facilities, and knowledge regarding NHIP.Conclusions Variables like education, family type, ethnicity, socio-economic status, prior experience of illness, utilization of health facility, knowledge regarding the annual premium amount, annual benefit ceiling, and renewal time found to be associated with NHIP enrollment.

Workshop on s-claim application system for BPJS claim officers at Grandmed Lubuk Pakam Hospital

BPJS Health is a public legal entity that is directly responsible to the President and functions to organize health insurance programs for all Indonesian residents, including foreigners who work for a minimum of six months in Indonesia. The BPJS Health claim procedure can be quite complicated and requires a lot of supporting documents. Unclearness in the guidance or instructions provided can make participants confused and not prepare the complete documents required, one of which is incomplete data files. This is a problem that slows down the claim process. This activity aims to provide health education on the application of the S-National Health Insurance (JKN) system, namely health protection program in Indonesia designed to provide basic health care and protection benefits for all Indonesian citizens. The main goal of JKN is to ensure that everyone in Indonesia has access to adequate basic health services, either through contributions paid by participants themselves or contributions paid by the government for certain groups. With the existence of JKN, it is hoped that the entire population of Indonesia can feel the benefits of equitable and quality health services, thereby improving the health status of the community as a whole. Claims to BPJS officers. The method of implementing activities is using observation sheets and questionnaires regarding the application of the S-Claim system to BPJS officers. Through this activity, it is hoped that the knowledge of BPJS claims officers can increase and change attitudes so that they can apply the BPJS E-Claim system correctly. Socialization to BPJS claims officers can be concluded that the knowledge of BPJS claims officers at Grandmed Lubuk Pakam Hospital has increased by 60% after conducting socialization using discussion, lecture and question and answer methods as well as holding quizzes or tests to evaluate participants' understanding of the S application.

ANALISIS KUALITAS LAYANAN MOBILE JKN MENGGUNAKAN METODE E-SERVICE QUALITY, CUSTOMER SATISFACTION INDEX (CSI) DAN IMPORTANCE PERFORMANCE ANALYSIS (IPA)

Mobile JKN is a non-face-to-face application that has many features and makes it easier for participants to maximize the national health insurance program organized by BPJS Kesehatan. As of June 2023, in the Surakarta area, the number of Mobile JKN registrations was 92,101 participants. Therefore, this research aims to analyze the level of quality of Mobile JKN services using e-service quality, customer satisfaction index (CSI) and importance performance analysis (IPA) methods. This research method uses quantitative methods. The object of this research was participants who came to the Surakarta branch of the BPJS Health office, totaling 100 participants. This research uses a questionnaire whose validity and reliability have been tested. The results of this research are that Mobile JKN participants are satisfied with Mobile JKN services, with an average gap value of 0.06 (positive value), and a CSI value of 81.4%, and the results of the IPA analysis have been described. There is great hope that the results of this research can become a reference for stakeholders to improve the quality of Mobile JKN services.

LIVESTOCK FARMERS RISK PERCEPTION AND WILLINGNESS TO PAY FOR LIVESTOCK INSURANCE IN FLOOD-PRONE AREAS OF PUNJAB

Pakistan is the world’s most susceptible country to extreme climatic events, such as floods. As such, for many years, the country has faced the risk of losses from natural calamities without crop insurance. However, in recent years, the national government has undertaken crop insurance initiatives in Pakistan. Consequently, there is limited knowledge available on the adoption of crop insurance in Pakistan. To fill this gap, this study aims to examine the factors influencing the willingness to pay for livestock insurance in flood prone areas of Punjab. Primary data were collected from 204 farm households through a structured interview in flood-prone areas of Punjab. Data was analyzed with descriptive statistics and logistics models. The explanatory analysis was used to further look at the socio-economic characteristics of livestock farmers through MS Excel and binary logistics models to test the willingness to pay livestock farmers for insurance. The results show a positive relationship between the perceived risk of Farmers and the willingness to pay for insurance programs. The findings of this study show that the probability of farmers' WTP is increased due to a better understanding of financial institutions and having more technical knowledge. The study results show that farmers with adult males are more likely to pay livestock insurance.

Socialization of The Use of BPJS for Services Inpatient Care at Pagar Jati Health Center Lubuk Pakam District

The national health insurance program is integrated into the Health Social Security Administering Body (BPJS Health). Through BPJS Health, the government is trying to ensure that all Indonesian citizens have fair and equitable access to quality health services without being constrained by costs. This program covers a variety of health services, from preventive services to treatment, with the hope of improving the welfare and health of the community as a whole. The JKN program is integrated into the Health Social Security Administering Agency (BPJS Health), a public legal entity that aims to administer the JKN program for all Indonesian people. This activity aims to provide health education about the use of BPJS for inpatient health services at the Pagar Jati Health Center. The method for carrying out activities is using observation sheets and questionnaires about the benefits of BPJS. From the results of the counseling provided, there was a significant increase in services, namely 86% compared to before the intervention was given. This indicates that the differences in the predisposing factors of BPJS patients significantly influence the utilization of inpatient services at the Pagar Jati Community Health Center. There is a significant influence on respondents' knowledge before and after being given counseling about the use of BPJS for inpatient services at the Pagar Jati Community Health Center, this can be seen from the percentage level knowledge before and after with a small percentage having insufficient knowledge. From the results of activities carried out by BPJS user patients, they were very enthusiastic about welcoming this activity. Through this activity, it is hoped that knowledge of the use of BPJS will increase so that you will no longer hesitate to use the BPJS card for inpatient health services at the Pagar Jati Community Health Center.

Burden of out-of-pocket payment for maternal healthcare and its catastrophic effects in the era of free maternal and child health policy in Ghana

BackgroundGhana introduced a free maternal healthcare policy within its national health insurance program in 2008. Despite this, there are reports of significant out-of-pocket (OOP) payments for maternal healthcare in Ghana. This study examines OOP payments for maternal healthcare services and their catastrophic effects, including the correlates of catastrophic OOP payments. MethodsCross-sectional quantitative data were collected from 414 mothers through health facility exit interviews in two regions of Ghana. Catastrophic OOP payments were computed by expressing total health expenditure as a percentage of household total expenditure and non-food expenditure at various thresholds (5 %, 10 %, 20 % and 25 %). The correlates of catastrophic OOP payments were assessed using logistic regression models. ResultsThe median OOP payments for maternal healthcare was GH₵866.5(US$109.3). The median non-medical OOP cost (GH₵479[US$ 59.9]) was higher than the median medical OOP cost (GH₵296.5[US$ 37.1]). The median OOP cost was higher for delivery (GH₵454[US$56.8]) compared to ANC (GH₵356.5[US$44.5]) and PNC (GH₵21.5[US$2.6]). Non-medical supplies comprise 58 % of the total OOP payments. About 73 % and 90 % of respondents spent more than 5 % of their annual household total and non-food expenditure on maternal healthcare, respectively. Rural areas and care at private facilities were significantly associated (AORs<1; p-values<0.05) with lower probabilities of incurring catastrophic OOP expenditure. Tertiary education was associated (AORs> 1; p-values<0.05) with a higher probability of incurring catastrophic OOP payments. ConclusionOOP payments for maternal care are still prevalent in Ghana. We call for a reform of Ghana’s free maternal healthcare policy to include non-medical supplies within its benefit package.

The Effect of Flood Exposure on Insurance Adoption Among US Households

AbstractDespite increasing exposure to flooding and associated financial damages, estimates suggest more than two‐thirds of flood‐exposed properties are currently uninsured. This low adoption rate could undermine the climate resilience of communities and weaken the financial solvency of the United States National Flood Insurance Program. We study whether repeated exposure to flood events, especially the disaster‐scale floods that are expected to become more frequent in a warming climate, could spur insurance adoption. Using improved estimates of residential insurance take‐up in locations where such insurance is voluntary, and exploiting variation in the frequency and severity of flood events over time, we quantify how flood events impact local insurance demand. We find that a flood disaster declaration in a given year increases the take‐up rate of insurance by 7% in the following year, but that the effect diminishes in subsequent years and is gone after 5 years. This effect is more short‐lived in counties in inland states that do not border the Gulf and Atlantic coasts. We also find that the effect of a flood on take‐up is substantially larger if there was also a flood in the previous year, and that recent disasters are more salient for homeowners whose primary residences are exposed to a disaster declaration compared to non‐primary residences. Overall, these findings suggest that relying on households to self‐adapt to increasing flood risks in a changing climate is insufficient for closing the insurance protection gap.

Leveraging browse and grazing forage estimates to optimize index-based livestock insurance

African pastoralists suffer recurrent droughts that cause high livestock mortality and vulnerability to climate change. The index-based livestock insurance (IBLI) program offers protection against drought impacts. However, the current IBLI design relying on the normalized difference vegetation index (NDVI) may pose limitation because it does not consider the mixed composition of rangelands (including herbaceous and woody plants) and the diverse feeding habits of grazers and browsers. To enhance IBLI, we assessed the efficacy of utilizing distinct browse and grazing forage estimates from woody LAI (LAIW) and herbaceous LAI (LAIH), respectively, derived from aggregate leaf area index (LAIA), as an alternative to NDVI for refined IBLI design. Using historical livestock mortality data from northern Kenya as reference ground dataset, our analysis compared two competing models for (1) aggregate forage estimates including sub-models for NDVI, LAI (LAIA); and (2) partitioned biomass model (LAIP) comprising LAIH and LAIW. By integrating forage estimates with ancillary environmental variables, we found that LAIP, with separate forage estimates, outperformed the aggregate models. For total livestock mortality, LAIP yielded the lowest RMSE (5.9 TLUs) and higher R2 (0.83), surpassing NDVI and LAIA models RMSE (9.3 TLUs) and R2 (0.6). A similar pattern was observed for species-specific livestock mortality. The influence of environmental variables across the models varied, depending on level of mortality aggregation or separation. Overall, forage availability was consistently the most influential variable, with species-specific models showing the different forage preferences in various animal types. These results suggest that deriving distinct browse and grazing forage estimates from LAIP has the potential to reduce basis risk by enhancing IBLI index accuracy.