From the Past one year of the scheme, 46.5 lakh hospital treatments were provided, amounting to claims worth Rs 7,490 crore
New Delhi: National Health Authority (NHA), the nodal agency for implementation of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) stated that the Health Benefits Packages (HBP) of the scheme have been revised. There has been an increase in the rate of 270 packages, the addition of 237 new packages, adoption of 43 stratified packages; and there is no change to the rate of 469 packages. NHA also mentioned that without compromising the range of treatment covered under PM-JAY, 554 packages will be discontinued, and there is a reduction in the rate of 57 packages. Overall, it was a conscious attempt to keep the price of abuse prone packages at the minimum level to minimize incentives for abuse.
“We are confident that with the revision in the Health Benefits Packages of Ayushman Bharat PM-JAY, many new private hospitals will get empanelled with the scheme. This will help to develop the access to good quality healthcare, and lakhs of vulnerable families will receive free treatment.”Dr Harsh Vardhan, Union Minister of Health and Family Welfare, said.
Dr Indu Bhushan, CEO NHA explained “In the spirit of cooperative federalism, before finalizing the changes, the feedback was also taken from the States and Union Territories. Their feedback was examined by the review committee”.
Bhushan said, “States and UTs which are using insurance model or a combination of Trust and insurance model shall have the autonomy to either continue using existing package master till their current contract period ends or shift to the new version after making suitable amendments in their contract”.
The revised oncology packages will revamp cancer care for the beneficiaries and are aligned to reflect the current best practices in the country. Dr Harsh Vardhan explained “These revised rates are expected to further augment cancer care in the country, along with a drastic reduction in the catastrophic expenses associated with it. Oncology packages have been split, into two multiple regimens of surgical and medical oncology, complemented by radiotherapy regimens.”
From the past one year of the scheme, 46.5 lakh hospital treatments were provided, amounting to claims worth Rs 7,490 crore. Fifty-three percent of the treatments were provided in private hospitals, and 60% were for tertiary care.
The NHA, along with experts from the Department of Health Research (DHR), Indian Council of Medical Research (ICMR) and Tata Memorial Hospital, was involved in the process to remove the inconsistencies in the nomenclature and pricing for their respective specialities.
The Hospitals to ensure that do not overcharge, and rates do not vary across hospitals, empanelled healthcare providers (EHCP) are paid based on specified package rates. A package consists of different costs associated with the treatment, including pre and post expenses of hospitalization.