Home/ News / India/  ‘Private hospitals avoid Ayushman Bharat PMJAY, citing low charges’

NEW DELHI : Authorities are trying to “motivate" more private hospitals to join the government’s flagship health scheme Ayushman Bharat PMJAY, targeting a sector that’s stayed away saying permissible charges are 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 nearly 2,000 treatment procedures across 27 specialities.

Ayushman Bharat aims to cover over 100 million poor and vulnerable families, or around 500 million individuals, providing a coverage of up to 5 lakh per family per year for secondary and tertiary care hospitalization.

So far, over 37 million hospital admissions have been authorized under the scheme, at a cost of 45,000 crore to the exchequer. “Onboarding of large number of private hospitals has always been an objective of National Health Authority. Recently, the health minister took stock of the process and held a meeting with multiple leaders of private hospitals and encouraged them to participate in PMJAY scheme," said a health ministry official requesting anonymity.

“Ayushman Bharat PMJAY has succeeded in the mission of safeguarding the lives of the beneficiaries and shielding their families from catastrophic health related expenditure. We encourage more and more hospitals to get empaneled under PMJAY, both private and government, as this will eventually help poor people in getting free and cashless treatment.

“However, most of the private hospitals find treatment package rates very low and that seems to be the reason that it does not interest most of these private healthcare providers," said another official at NHA.

“Regular meetings with top corporate hospitals are being held to motivate them. Some of them were facing issues of delay in claim process settlement, so we streamlined it and started Green Channel Payment initiatives, quality initiatives in which bronze, silver, gold certificates are issued to the hospitals as per their quality performances, award to best performing hospitals and doctors, imparting training to doctors on standard treatment guideline and focused on smoothening the empanelment process. These are the some of the activities we have taken to encourage hospitals," said a third official.

“The government invited us recently and I cited our experience with Central Government Health Scheme (CGHS) where a lot of hospitals have their outstanding bills. Similarly, in the case of PMJAY most of the bigger hospitals are not confident that their bills be cleared on time," said Dr Girdhar Gyani, Director General, Association of Healthcare Providers of India (AHPI)

“Most of the private hospitals empaneled under PMJAY are small hospitals. PMJAY needs giant private hospitals because smaller hospitals cannot provide tertiary care procedures. Besides, most of the small private hospitals in the states are also not getting incentives. PMJAY should also revise the package rates which are very low."

Queries mailed to the health ministry spokesperson did not elicit a response.

Priyanka Sharma
Priyanka Shamra is a health and pharma journalist with nearly nine years of field reporting experience. She is a special correspondent with Mint. Her beat includes covering the Ministry of Health and Department of Pharmaceuticals. She also covers the Ministry of Women and Child Development and the Department of Biotechnology.
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Updated: 02 Sep 2022, 06:26 AM IST
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