Private hospitals have treated 68% of PMJAY beneficiaries
In a big boost for the Modi government's Ayushman Bharat-Pradhan Mantri Jan Aarogya Yojana (AB-PMJAY) program, data released by the National Health Agency (NHA) has revealed that around 2.3 lakh beneficiaries have used the scheme to avail of healthcare in the first two months since it was launched. Further, among these beneficiaries, 68% have received treatment at private hospitals. Here are the details.
Details about the government-funded health insurance scheme
Under the scheme, beneficiary families are entitled to an annual health insurance of up to Rs. 5 lakh for secondary and tertiary hospitalization. This health insurance will be available for 1,350 medical procedures. No cap has been set on family size and age to ensure inclusivity.
Maximum Ayushman Bharat beneficiaries are from Gujarat
NHA data has revealed that 2,32,592 beneficiaries have availed of the government-funded health insurance program for hospitalization since it was rolled out on September 23. Among them, 68% received treatment at private hospitals while the rest received treatment at government hospitals. In terms of region-wise distribution, the maximum beneficiaries were in Gujarat, followed by Tamil Nadu, Maharashtra, Chhattisgarh, and West Bengal respectively.
Oral and maxillofacial surgery accounted were the most sought-after treatments
In terms of treatments claimed, oral and maxillofacial surgery, general surgery, general medicine, ophthalmology, obstetrics and gynaecology were the most sought-after treatments. Since these treatments include head surgery, it could indicate that accident cases accounted for a significant number of the claims. This wouldn't be surprising either, considering the frequency of road accidents in India.
Why the findings are significant
The findings, especially the fact that a majority of the cases were getting treated at private hospitals, are particularly significant given initial concerns about pricing problems. Private hospitals had initially raised questions about the low price of treatment packages fixed by the NHA, leading many to doubt the potential of the scheme, which relies on a network of empanelled hospitals to provide treatment.
Ayushman Bharat deputy-CEO: Costing issues exist only in metro cities
"Costing issues are primarily in Delhi and in other metro cities where the cost of services and human resources is high. Otherwise, the response from tier 2 and 3 cities in states like Haryana, UP, Jharkhand, and Chhattisgarh is tremendous," said Ayushman Bharat deputy CEO Dinesh Arora.
15,000 empanelled hospitals, 55,482 applications received
While data for the first two months are encouraging, the Ayushman Bharat scheme is looking to empanel many more hospitals. Currently, 15,000 hospitals, of which 8,000 are private hospitals, are empanelled or in queue for empanelment. Meanwhile, the government has received a whopping applications for empanelment from a whopping 55,482 hospital, and empanelments are bound to rise over time.
