New Delhi, Sep 23 : As the Ayushman Bharat scheme completes a year with more than 46 lakh beneficiaries enrolled, issuing cards to families still not covered, more coordination with other insurance schemes, empanelling more hospitals, building the new IT ecosystem and framing a innovation strategy for health solutions will be among the priorities for implementing authority National Health Authority in the coming year.
Ayushman Bharat, also known as the Pradhan Mantri Jan Arogya Yojana (PM-JAY), was launched by Prime Minister Narendra Modi on September 23, 2018 at Ranchi. In the one year period, 46.4 lakh hospital treatments, worth Rs 7,500 crore, have been carried out.
PM-JAY is a flagship scheme of the Modi government with an aim to bring quality healthcare to around 50 crore poor and vulnerable Indians across India. Giving annual healthcare benefits of up to Rs 5 lakh for every entitled family, it is the world's largest fully government funded health insurance scheme.
As the scheme completes one year, sources said the NHA has identified giving coverage to poor and vulnerable families who are still not covered as one of the important priorities in the coming year. Efforts will be made at ensuring that the entitled beneficiaries are issued their e-cards as soon as possible. More than 10 crore cards have been issued under the scheme.
Development of close coordination mechanism with various other health insurance/assurance schemes also needs to be done which will result in improved effectiveness and efficiency for all such schemes, the sources said.
The NHA will also aim to empanel more tertiary care and secondary care hospitals across the country to provide better access. Focusing on improving the quality of services provided in the empanelled hospitals is another important area on which the NHA will focus in the next year. The hospitals empanelled under the scheme are 18,236, out of which 53 per cent are private and have carried out 62 per cent of the total treatments.
The NHA is building PM-JAY 2.0, the new and upgraded IT ecosystem focussed on enhancing beneficiary awareness, access to quality affordable healthcare and on increasing the operational efficiency and monitoring of the scheme, the sources said.
PM-JAY 2.0 will be comprised of a suite of systems with state-of-the-art advancements.
For instance, the NHA has recently set up One Transaction Management System (TMS) the entire transaction engine for AB-PMJAY. A CHCP (Common Health Claims Platform), the key to interoperability and convergence in health insurance and assurance ecosystem is being set up.
The NHA has formulated an innovation strategy for leading the effort for an open embrace of innovations for speeding up progress on providing open access to high quality healthcare at patient-friendly affordable prices.
Within the health ecosystem, there are various innovators working on developing solutions which can increase the efficacy of health service delivery, the sources said. There is a greater need to cultivate a landscape of synergies fixated on innovations centered around the Indian healthcare system to constantly evolve and deliver better outcomes through PM-JAY, they added.
As part of this novel effort, the NHA will be launching the Ayushman Bharat PM-JAY Start-up Grand Challenge at the first anniversary celebrations of the AB-PMJAY. The NHA Innovation Unit (NIU) has been established to lead the creation and implementation of NHA's innovation strategy and facilitate creation of a robust innovation pipeline to help mainstream home growninnovations to the health ecosystem.
Among the lessons learnt during the first year was the fast scaling up due to the partnership model adopted by the NHA where it has partnered with various international and national agencies, the sources said. It partnered with the Common Service Centres (CSC) under Ministry of Electronics and IT to conduct the beneficiary identification and verification exercise across the country.
With the engagement of over 2 lakh village level entrepreneurs, the CSCs have verified more than 3.5 crore beneficiaries and generated more than 3 crore e-cards, reaching to the remotest corners of the country.
The partnership with the National Skill Development Corporation has resulted in trained skilled human resources to manage help desks at the hospitals. More than 16,000 plus Pradhan Mantri Arogya Mitras(PMAMs) have been trained so far, the sources said.