One year of Ayushman Bharat, A overview

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Ayushman Bharat has brought forty percent of India$B!G(Bs population under hospital insurance in first year – A remarkable feat. It can be the platform for creating a universal health coverage in India with comprehensive benefits using digital health  and frontier technologies: NATHEALTH

New Mumbai, September 23, 2019: On the occasion of one year of effective and successful implementation of Ayushman Bharat Mission with its two critical components- Pradhan Mantri Jan Aarogya Yojna (PMJAY) and Health and Wellness Centres (HWCs), apex healthcare industry body- Healthcare Federation of India NATHEALTH congratulated the program for improving access and affordability of healthcare in India and opening a pathway for a robust healthcare model in India which benefits all citizens.  NATHEALTH has collaborated with nodal agency National Health Authority on benefit package pricing, design and innovations required to scale up the Aprogram.

Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB$B!>(BPMJAY) is the flagship scheme of Government of India that provides a cover of up to Rs. 5 lakhs per family per year, for secondary and tertiary care hospitalisation to over 10.74 crore vulnerable entitled families (approximately 50 crore beneficiaries).

As on September 20, 2019 over 44 lakh patients were hospitalised and benefitted by the scheme. In one year, the government has issued e-cards for over 10 crore people from the weaker section. Under this scheme, there are 1,393 health benefits packages with defined rates. Over 18,000 hospitals and health care providers have been empanelled across the country to provide healthcare services as per these packages.

Based on its success, NATHEALTH strongly recommended scaling of PMJAY which would pave way for universal health insurance to those excluded so far.

$B!H(BIn a very short time, Ayushman Bharat has benefited millions in India directly and has clearly improve access, affordability and equity of healthcare. We need scale this program with quality and sustainability for all stakeholders. The focus needs to be on coverage of those who are outside the ambit of healthcare. Expansion of coverage to include to lower-middle and middle class needs to be a priority, going forward,$B!I(B said Dr H Sudarshan Ballal, President, NATHEALTH.

$B!H(BFor scaling up the program, we need to strengthen delivery mechanism which includes expansion of private providers$B!G(B network, shift towards organised care delivery, innovations, speciality, low cost, and value-based care. The package rates for private providers remained an unsettled issue in the past year. We have extended support to the government in the calibration of package rates and the development of standard treatment protocols based on global practices to ensure quality healthcare across India,$B!I(B  he added.

With Public-Private Partnerships, (PPP), India can create a Health System that is sustainable and provides affordable, accessible and quality healthcare for masses and create skilled employment,$B!I(B he added.

$B!H(BAlong with Delivery and Quality, for long term sustainability, we need to adopt innovative funding models. Higher public spending in the form of budgetary allocation, India needs to attract strategic funding through various other internal and external sources to sustain not only Ayusham Bharat Mission but entire healthcare delivery system in the country. With adequate financing and funding to the sector, rural-urban gaps in quality and delivery systems can also be bridged,$B!I(B said Mr Siddhartha Bhattacharya, Secretary-General, NATHEALTH.

Going forward, the healthcare industry would be looking forward to bigger participation and partnership to drive innovations to achieve the goal of universal health coverage and for a $B!F(B Swastha Bharat.$B!G(B  Because of the very low penetration of health insurance in the country and high out-of-pocket spending for healthcare services, universal health insurance would act as a powerful catalyst for effective management of population health. According to NATEALTH, bigger partnerships and participation would work efficiently in supporting public health agenda, be it NCD awareness, high-risk screening or universal immunization. For the long term success, sustainability and to make health insurance universal, speciality hospitals need to be on board and for that, a new model with rational pricing has to be in place.