New Delhi
A major information has been revealed about the Government of India’s ambitious Health Scheme, Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), which started in the year 2018. According to government data, since the launch of this scheme, more than 600 private hospitals have voluntarily decided to be out of it. These hospitals have separated themselves from the scheme citing reasons like delayed payment and low remuneration rate.
Most of the hospitals in Gujarat were out
The state of Gujarat has the highest number of private hospitals to separate themselves from Ayushman Bharat Yojana. Here 233 hospitals decided to be out of the plan. After this, 146 hospitals in Kerala and 83 hospitals in Maharashtra have also taken similar steps. According to the data shared by Minister of State for Health and Family Welfare Prataprao Jadhav in the Rajya Sabha, a total of 609 private hospitals have been out of the scheme so far. This situation has become a matter of concern for the scheme, which aims to provide health protection to 10 crore families or about 50 crore people of the country.
Complaints of private hospitals
Private hospitals say that low rates and delays in payment under the scheme are making them difficult for them. Many hospitals have claimed that they did not get timely money due to the state governments not issuing funds on time, which is unable to continue participation in the scheme. For example, under the Haryana unit of the Indian Medical Association (IMA), hundreds of private hospitals announced the shutdown under the scheme in February, as there was an outstanding payment of more than Rs 400 crore. After this, private hospitals and nursing homes association in Punjab and Jammu and Kashmir also Demanded a similar suspension.
In states like Chhattisgarh and Gujarat, some treatment packages are also coming out of it due to being reserved for government hospitals and no referral from government hospitals. In response to a question asked in the Rajya Sabha, Minister of State for Health Prataprao Jadhav said that the National Health Authority (NHA) has set guidelines within 15 days of filing claims for inter-state hospitals and within 30 days to pay claims to hospitals within 30 days for portability hospitals (located outside the state).
The purpose of the scheme and the current status
The Ayushman Bharat Yojana was launched by Prime Minister Narendra Modi on 23 September 2018 in Ranchi, Jharkhand. The scheme provides free health insurance up to Rs 5 lakh per year to poor and weaker families. The plan initially consisted of about 10.74 crore poor and weaker families, which according to the 2011 Socio Economic and Caste Census (SECC) constitutes 40 percent of India’s population. Later in January 2022, the beneficiary Aadhaar was revised to 55.0 crore persons or 12.34 crore families. In 2024 alone, the scheme was expanded to 37 lakh Asha and Anganwadi workers and their families for free healthcare benefits, and at the end of the year the government announced to include about 6 crore senior citizens aged 70 years and above. Later, Odisha and Delhi became the 34th and 35th state or union territory (UT) to join PMJAY, which led to more than 70 lakh families under the scheme.
Government’s answer
The government says that it is taking steps to solve this problem. Ankita Adhikari, a joint CEO of Ayushman Bharat in Haryana, recently said that the process of issuing funds has been started and the situation will be handled within a week. In addition, the central government has taken seriously the complaints of private hospitals and said to review the package rates and to speed up the payment process.
challenges ahead
Although the scheme has so far benefited several crore patients and Ayushman cards have been issued to about 36 crore people, but the exclusion of private hospitals can become a threat to its future. Experts believe that if the payment system is not improved, then more hospitals can be out of this scheme, the most damage to the poor and needy Patients will have.
The biggest challenge before the government is to ensure that private sector participation is maintained and health services are not affected by the government. There is a need to take concrete steps in this direction, so that this plan can fulfill its original objective.
