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Minister’s reply shows much more needs to be done in PM Ayushman's Health scheme: MP Arora

July 31, 2023 05:09 PM

Ludhiana: A few questions asked by MP (Rajya Sabha) Sanjeev Arora about Ayushman Health Scheme in the Rajya Sabha have yielded a remarkably interesting reply.

The Union Minister of State for Health and Family Welfare Prof SP Singh Baghel has replied to Arora’s questions.

Arora had asked whether the average number of beds per hospital registered under Ayushman health scheme is around 48 and is very low; the steps taken by government to make sure that larger hospitals also get themselves registered under this scheme; whether the critical treatments cannot be taken care by smaller hospitals; whether spend per patient under this scheme is around 10 thousand against a limit of 5 lakhs; and the steps taken by government to increase this spend per patient as it looks like that critical care patients are not being treated under this scheme.

Giving this information, Arora said the Minister tabled his reply in the House mentioning that State Health Agencies (SHAs) are mandated with the responsibility of empaneling hospitals under Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY).

Intending private hospitals get empaneled after fulfilling the laid down criteria and are subject to the requirement of SHA within a given State/UT. States/UTs are also given flexibility to change hospital empanelment criteria based on the local requirement.

As of 20th July 2023, a total number of 27,045 hospitals including 11,908 private hospitals are empaneled under the scheme. The number of beds corresponding to 27,045 hospitals is 13.27 lakh, which averages out to 49 beds per hospital.

Further, the Minister replied that all government hospitals with in-patient services are deemed empaneled under AB-PMJAY. Accordingly, smaller hospitals are also empaneled under the scheme.

Many single specialty hospitals cater to high-end treatment for such specialties. The empanelment policy of the scheme aims at ensuring access to quality healthcare services at the shortest distance.

The Minister also mentioned that National Health Authority (NHA) follows up with prominent corporate hospital chains for empanelment under the scheme.

Participation of the hospitals are encouraged through rationalization of Health Benefit Packages (HBPs), timely settlement of claims and redressal of grievances, if any.

Prof Baghel further mentioned that as of 19th July 2023, 5.39 crore hospital admissions worth Rs.66,236 crore including States share of expense have been authorized under the scheme. These treatments span across 1,949 procedures under 27 different specialties including oncology, ophthalmology, nephrology, and cardiology etc.

The average cost of per episode of hospitalization under the scheme is Rs.12, 275 due to the high number of treatments costing from few thousands to few lakhs.

Further, there is a provision of one unspecified package to ensure that eligible beneficiaries are provided treatment for critical ailments which can lead to catastrophic healthcare expenditure.

Reacting to the Minister’s statement Arora said it is astonishing that the average spending per patient under this scheme is Rs.12, 275 against a limit of 5 lakhs.

Moreover, the reply indicates that mostly small hospitals are empaneled under the scheme, and this is why there is availability of average 49 beds per hospital.

He urged upon the government to find out reasons as to why big hospitals are not coming up under this scheme. He remarked that the Minister’s reply is crystal clear that the patients are not being given complete benefit and facilities under the scheme, which is a matter of great concern.

According to Arora much more needs to be done to make this scheme completely successful.


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