New Delhi : Officials are trying to “motivate” more private hospitals to join the government’s flagship health scheme Ayushman Bharat PMJAY, targeting an area where the permissible fee is too low.
As of now, PMJAY has a network of 25,000 empaneled hospitals – both private and public – with a 42% (11,000) share of private healthcare providers. They offer approximately 2,000 treatment procedures in 27 specialties.
Ayushman Bharat aims to cover over 100 million poor and vulnerable families, or about 500 million individuals, 5 lakh per family per year for secondary and tertiary care hospitalization.
More than 37 million hospital admissions have been authorized so far under the scheme 45,000 crore in the exchequer. “Inclusion of a large number of private hospitals has always been an objective of the National Health Authority. Recently, the health minister took stock of the process and held a meeting with several leaders of private hospitals and encouraged them to participate in the PMJAY scheme,” said a health ministry official requesting anonymity.
“Ayushman Bharat has been successful in the mission of protecting the lives of PMJAY beneficiaries and their families from disastrous health related expenses. We encourage more and more hospitals, both private and government, to get empaneled under PMJAY, as this will ultimately help poor people to get free and cashless treatment.
“However, most of the private hospitals have very low treatment package rates and that is why it does not interest most of these private healthcare providers,” said another NHA official.
“Regular meetings are being held with top corporate hospitals to motivate them. Some of them were facing issues of delay in claim process settlement, so we streamlined it and started Green Channel Payment Initiative, a quality initiative in which Bronze, Silver, Gold certificates are issued to hospitals as per their quality performance , Awards to best performing hospitals and doctors training doctors on standard treatment guidelines and focus on facilitating the empanelment process. These are some of the activities that we have done to encourage hospitals,” said a third official.
“The government invited us recently and I cited my experience with the Central Government Health Scheme (CGHS) where there are a lot of hospital bills outstanding. Similarly, in case of PMJAY most of the big hospitals are not confident that their bills will be met on time,” said Dr Girdhar Giani, Director General, Association of Healthcare Providers of India (AHPI).
“Most of the private hospitals listed under PMJAY are small hospitals. PMJAY needs huge private hospitals as small hospitals cannot provide tertiary care procedures. Moreover, most of the small private hospitals in the states are also not getting incentives. PMJAY should also revise package rates which are very low.”
Queries sent to the Health Ministry spokesperson did not elicit any response.
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