According to information provided to the Lok Sabha by Union Health Minister J P Nadda, the government’s premier health insurance program, Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), has grown significantly, with over 29,000 hospitals, including 12,625 private hospitals, empanelled as of June 30. With their various State Health Agencies (SHAs), each of these hospitals has a written agreement in place.
AB-PMJAY seeks to offer secondary and tertiary care hospitalization to economically disadvantaged households at no cost. The program has a strong grievance redressal mechanism in place to handle any problems beneficiaries may have. Recipients have various options to file complaints about treatment denials or other scheme-related matters. These include contacting state and central call centers, the Centralized Grievance Redressal Management System (CGRMS), or writing directly to SHAs. Furthermore, hospitals found to be in violation of SHA regulations may face consequences up to and including de-empanelment.
Based on the quantity of treatments rendered, empanelled hospitals’ performance is tracked under AB-PMJAY; this data is dynamic and updated on a regular basis. Hospital empanelment is a continuous procedure designed to guarantee greater access to healthcare services by growing the network. A multifaceted approach is used to do this, including arranging workshops to address concerns, reaching out directly to hospitals and their associations, and streamlining the empanelment processes. The number of hospitals joining the program has steadily increased as a result of these actions.
Uttar Pradesh has experienced notable regional involvement, with 2,948 public and 2,634 private hospitals empanelled. Andhra Pradesh has 1,027 private and 1,406 public hospitals covered by the program, whereas Tamil Nadu has 1,202 private and 996 public hospitals. Whereas Bihar lists 564 private and 2,968 public hospitals, Gujarat has 868 private and 1,747 empanelled public hospitals. There are 10 private and 27 public hospitals in West Bengal, and there are 52 private and 11 public hospitals empanelled in Delhi. Odisha exhibits fewer numbers, with 11 public and 1 private hospitals taking part.
This vast network makes sure that a wide range of people can receive free healthcare services, which increases the program’s efficacy and reach. The government’s commitment to enhancing healthcare accessibility and quality for the most disadvantaged parts of society is evidenced by the ongoing empanelment process and deliberate initiatives to involve additional facilities. The Indian government hopes to provide universal healthcare coverage and lessen the financial burden of medical costs on households that are already struggling financially through AB-PMJAY.
SOURCE:
TIMES OF INDIA
