Govt woos private hospitals to expand Ayushman Bharat health insurance programme

The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), Prime Minister Narendra Modi's pet health insurance scheme, offers  families health cover of up to Rs500,000 a year for serious ailments - a significant amount for most low-income families in india, but too low for healthproviders who have invested large sums in infrastructure and medical equipment.

The scheme has so far registered about 20 per cent of the eligible 500 million people, due to lack of public awareness of the scheme and low private sector participation.

A Reuters report citing Indu Bhushan, CEO of the National Health Authority (NHA), which runs the programme, said, “There is a challenge of creating awareness and building the required infrastructure,” adding, “We need to work more on awareness ... give us time.”

The healthcare programme, however, has benefited more than 6 million people who have received free-of-cost medical treatment, he pointed out.

Launched last year, the scheme is critical to Prime Minister Narendra Modi’s plans to reform the country’s health system, where private healthcare is too expensive for most people and public hospitals are overburdened and often ill-equipped for treating major ailments.

Currently, 60 per cent of the approximately 20,000 hospitals registered under the programme are in the private sector, Bhushan said, adding that increasing their participation was critical to the success of the scheme.

With the Rs5,00,000 cover offered by the government covering hardly even 40 per cent of the average cost of treatment they offer, private hospitals art not interested in accepting AB-PMJAY patients. 

A report by the Federation of Indian Chambers of Commerce and Industry (FICCI) and consultants EY said in August that private hospitals are not ready to accept the treatment rates offered by the NHA.

Bhushan said his agency was in talks with hospitals, industry groups and service providers and was open to revising rates, even though he had last month increased payments offered to hospitals for some treatments.

“We are hoping that private sector would come. If rates are not viable, private sector will not come,” he told Reuters.

The NHA’s budget spending will be around Rs5,000-5,500 crore against current year allocation of Rs6,200crore.The NHA is planning to expand the scheme and is likely to seek at least Rs8,000 crore for the next year.

Minister of state for health and family welfare Ashwini Kumar Choubey, meanwhile, informed the Lok Sabha in a written reply that  the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is being implemented in Kerala with effect from 1 April 2019, although the state delayed the scheme till the end of the scheme as it was implementing the Rashtriya Swasthya Bima Yojana and a state scheme Comprehensive Health Insurance Scheme. With the launch of AB-PMJAY – Karunaya Arogya Suraksha Padhathi (KASP), both the pre-existing schemes have been subsumed in it.