Modi's Ayushman Bharat scheme: On-boarding state hospitals a challenge

The Ayushman Bharat team is persuading government hospitals to be an active part of the scheme

After national roll-out of the ambitious Pradhan Mantri Jan Aarogya Yojana (PMJAY), to provide insurance cover for poor families up to Rs 500,000 in a year for critical in-patient treatment, the team in charge is busy ironing out issues with states.

On-boarding of government hospitals seems a challenge in, for instance, Uttar Pradesh, Bihar, and Madhya Pradesh. 

Senior members of the scheme, widely referred to as Ayushman Bharat, are visiting states to ensure adequate training of hospital staff (using information technology systems) and the Aarogya Mitras (facilitators in the empanelled hospitals). 

The latter are to help beneficiaries with the verification and authentication process, grievance redressal, handling of emergency cases and to manage queries. The aim is at least 100,000 Aarogya Mitras by the end of this year. 

The Ayushman Bharat team is also persuading government hospitals to be an active part of the scheme. A senior official says, “Public hospitals in some of these states are unwilling to participate. Their argument is that they are already treating patients for free. They feel adding of beneficiaries will only add to their burden.” 

The official says their team is trying to convince these hospitals, noting the government would pay to treat these additional beneficiaries. This additional money could be used by the hospitals to augment capacity. 

Chhattisgarh’s government, sources say, are trying to onboard hospitals by the promise of additional funds that will reduce the dependence on state funds for expansion and upgradation. 

Also, around 10 states are adding their own beneficiaries to the scheme. In many like Chhattisgarh, Tamil Nadu, Uttar Pradesh, and Himachal Pradesh, the Socio-Economic Caste Census’ 2011 data excludes many below-poverty-line families. To include them, some states (Haryana, for instance) are planning an additional scheme, with a family paying a nominal premium and the state taking care of the rest. 

As the list stands, Punjab, Delhi, and Odisha are among those that have not signed for the Ayushman Bharat scheme. 

As the former Rashtriya Swasthya Bima Yojana (RSBY) has been subsumed under this, these states will lose grants for RSBY as well.