Daily hospitalisation under PMJAY may double by January

By: | Updated: November 30, 2018 6:33 AM

The number of free hospitalization beneficiaries under the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) may reach 6 lakh in the next one month from 3.7 lakh now, Ayushman Bharat CEO Indu Bhushan told FE.

PMJAY, Ayushman Bharat CEO, Indu Bhushan, National Health Agency, free hospitalization beneficiaries To overcome this, the National Health Agency (NHA), which administers PMJAY, is directly negotiating and has so far roped in three private hospitals in Delhi including Cygnus Sonia Hospital and Dr Shroff’s Charity Eye Hospital.

The number of free hospitalization beneficiaries under the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) may reach 6 lakh in the next one month from 3.7 lakh now, Ayushman Bharat CEO Indu Bhushan told FE. This is even as efforts are on to empanel more branded specialty hospitals under the scheme, which offers Rs 5-lakh-a-year health cover to 10.7 crore households.

“We expect the average hospitalization rate to rise from 6,000-7,000/day to about 12,000/day by January 1, 2019. In the first 100 days of the scheme, we are expecting about 6 lakh people to get hospitalization benefits,” Bhushan said.
Currently, 57% of the empaneled 14,416 hospitals are from private sector, which also treated 66% of the patients under the scheme. As on November 27, a total of 3,65,860 beneficiaries were admitted to hospitals for undergoing various surgeries and procedures. However, bulk of the hospitals empaneled under the PMJAY are not accredited to the NABH (National Accreditation Board for Hospitals and Healthcare Providers) or other similar agencies offering quality certification. These data, however, are not fully captured as states that had similar schemes earlier and later joined PMJAY are yet to integrate their data with the national database.

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“As the scheme matures and payments are streamlined, greater percentage of hospitals in PMJAY would be branded,” Bhushan said. Medanta in Gurugram, Apollo in Chennai and Narayana Hrudayalaya in Bangalore are some of the top branded and super specialty hospitals which are already empaneled after the scheme was rolled out on September 23.
Delhi houses a large number of specialty private hospitals that are visited by patients from across the country.

However, Delhi has not joined the scheme so far (Telengana and Odisha being the other two), thereby slowing down the empanelment of private hospitals in the capital (as it’s the state’s job to empanel). To overcome this, the National Health Agency (NHA), which administers PMJAY, is directly negotiating and has so far roped in three private hospitals in Delhi including Cygnus Sonia Hospital and Dr Shroff’s Charity Eye Hospital. “Big hospitals are coming. We are hoping more will join soon,” Bhushan said, adding that the scheme is only two-month old and will take time to mainstream.

Even though there were no plans to issue beneficiary cards (as they are automatically selected from Socio Economic and Caste Census data), NHA plans to issue about five crore such cards to inform people and generate hospitalization demand from rural population. So far, about 10 lakh cards have been issued.

The hospitalization and treatment of 3.65 lakh up to now would cost the Centre and states about Rs 500 crore, shared in 6:4 ratio between the two. The cost of the scheme would be much lower in FY19 as half of the year is over and some populous northern states implementing such a scheme for the first time would take time to fully roll it out.

For 2018-19, Bhushan said the PMJAY might cost the Centre about Rs 4,000 crore (including one-time investments on IT) and the states about Rs 1,600 crore in 2018-19. The scheme might provide hospitalization benefits to 25 lakh in the current fiscal year. So far, bulk of the beneficiaries are from Gujarat, Tamil Nadu, Chattisgarh, Karnataka and Maharashtra, the states which had prior experience of similar schemes. Most of the states are also implementing the scheme under trust model.

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