Specialised treatment tops Ayushman Bharat-PM-JAY medical health insurance scheme- The Recent Indian Express

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Express News Service

NEW DELHI: Chemotherapy, neonatal procedures, minimal invasive surgeries to open blocked coronary arteries or (PTCA), heart failure and surgeries to remove kidney stones are the highest five procedures availed within the last one 12 months by the beneficiaries of the Ayushman Bharat-PM-JAY medical health insurance scheme. 

“People have availed advantages under AB PM-JAY for treatment of varied diseases, particularly the ailments which constitute the very best disease burden and economic hardship attributable to incurring healthcare expenditures,” R S Sharma, the National Health Authority (NHA) Chief Executive Officer, said.

The scheme, billed because the world’s largest government-funded public medical health insurance scheme, seeks to offer 50 crore beneficiaries with a health cover of Rs 5 lakh per family per 12 months for secondary and tertiary care hospitalisation in each private and government hospitals.

As Cancer deaths and cases are increasing rapidly in India, the highest draw for the common people availing the cashless and paperless insurance scheme is chemotherapy. Nearly 7 lakh chemotherapy procedures have been conducted at tertiary care centres under the ambitious flagship government programme. The second most sought-after procedure is neonatal care procedures. Around 1.7 lakh have been done.

PTCA surgeries, which assist in improving blood flow to the center muscle without open-heart surgery, have been the third highest medical procedure done at the varied tertiary healthcare centres which have been authorised under the scheme.

The fourth procedure that’s availed by the beneficiaries is congestive heart failure or heart failure procedures, which might sometimes be life-threatening if proper and immediate medical treatment just isn’t provided in time. About 41,000 such medical treatments were provided to individuals who couldn’t have otherwise been in a position to access and afford such costly healthcare.

Percutaneous Nephrolithotomy (PCNL), a way used to remove specific stones within the kidney or upper ureter, was the fifth most surgery – over 35,000 – that was availed by people within the last 12 months.

Sharma also said the procedures relevant to cardiology, oncology, renal diseases, and general medicine, which cover secondary and tertiary care, are a number of the top packages.

He added that the opposite health packages which feature among the many top utilised procedures include cataract surgery, caesarean delivery for high-risk pregnant women, severe anaemia and enteric fever or typhoid fever.

The whole value of authorised hospital admissions for the highest medical and surgical interventions through the previous 12 months is roughly Rs. 4,126 crores in secondary and tertiary care.

During 2021-22, a complete of 1.52 crore hospital admissions have been authorised under AB PM-JAY. The whole value of such hospital admissions involves about Rs. 14,957 crores till May 25 this 12 months, Sharma told this newspaper.

“We aim to extend the scope and scale of the scheme. Some states with higher utilisation of those top medical and surgical packages are Kerala, Karnataka, Madhya Pradesh, Gujarat, Uttar Pradesh and Chhattisgarh, amongst others,” Sharma said.

The NHA head said that at AB PM-JAY, particular emphasis is given to making sure that beneficiaries can access services at any location, including their residence. 

“We’ve got empanelled a network of around 25,000 hospitals across the country. Of those, around 9,000 hospitals are in aspirational districts. Further, under AB PM-JAY, a ten per cent incentive is provided for all procedures carried out in hospitals situated in aspirational districts over and above the bottom package rates to encourage their participation,” he said.

There are 112 most under-developed districts across the country, and the federal government goals to quickly and effectively transform these districts to lift people’s living standards.

Under the scheme, a network of nearly 25,800 private and non-private hospitals has been developed, of which 10,700 are private healthcare facilities, whereas 15,100 are public healthcare establishments.

Many states have also relaxed the empanelment criteria in certain districts with inadequate health infrastructure to make sure an adequate variety of hospitals for the scheme beneficiaries.

“Because the scheme matures, it can assist in catalysing investment into healthcare infrastructure in under-served areas by fostering demand for healthcare services from the eligible beneficiaries,” he added.

He added that one could consider AB PM-JAY as an aggregator platform wherein healthcare providers can plug in to serve the needs of beneficiaries and earn a viable income.

Over 18 crore cards have been issued because the launch of the scheme in 2018 till May this 12 months. Based on the union health ministry, greater than 3 crore 20 lakh people have availed the good thing about hospital facilities, and hospital admission amount to 37 thousand 398 crore rupees till May this 12 months.

NEW DELHI: Chemotherapy, neonatal procedures, minimal invasive surgeries to open blocked coronary arteries or (PTCA), heart failure and surgeries to remove kidney stones are the highest five procedures availed within the last one 12 months by the beneficiaries of the Ayushman Bharat-PM-JAY medical health insurance scheme. 

“People have availed advantages under AB PM-JAY for treatment of varied diseases, particularly the ailments which constitute the very best disease burden and economic hardship attributable to incurring healthcare expenditures,” R S Sharma, the National Health Authority (NHA) Chief Executive Officer, said.

The scheme, billed because the world’s largest government-funded public medical health insurance scheme, seeks to offer 50 crore beneficiaries with a health cover of Rs 5 lakh per family per 12 months for secondary and tertiary care hospitalisation in each private and government hospitals.

As Cancer deaths and cases are increasing rapidly in India, the highest draw for the common people availing the cashless and paperless insurance scheme is chemotherapy. Nearly 7 lakh chemotherapy procedures have been conducted at tertiary care centres under the ambitious flagship government programme. The second most sought-after procedure is neonatal care procedures. Around 1.7 lakh have been done.

PTCA surgeries, which assist in improving blood flow to the center muscle without open-heart surgery, have been the third highest medical procedure done at the varied tertiary healthcare centres which have been authorised under the scheme.

The fourth procedure that’s availed by the beneficiaries is congestive heart failure or heart failure procedures, which might sometimes be life-threatening if proper and immediate medical treatment just isn’t provided in time. About 41,000 such medical treatments were provided to individuals who couldn’t have otherwise been in a position to access and afford such costly healthcare.

Percutaneous Nephrolithotomy (PCNL), a way used to remove specific stones within the kidney or upper ureter, was the fifth most surgery – over 35,000 – that was availed by people within the last 12 months.

Sharma also said the procedures relevant to cardiology, oncology, renal diseases, and general medicine, which cover secondary and tertiary care, are a number of the top packages.

He added that the opposite health packages which feature among the many top utilised procedures include cataract surgery, caesarean delivery for high-risk pregnant women, severe anaemia and enteric fever or typhoid fever.

The whole value of authorised hospital admissions for the highest medical and surgical interventions through the previous 12 months is roughly Rs. 4,126 crores in secondary and tertiary care.

During 2021-22, a complete of 1.52 crore hospital admissions have been authorised under AB PM-JAY. The whole value of such hospital admissions involves about Rs. 14,957 crores till May 25 this 12 months, Sharma told this newspaper.

“We aim to extend the scope and scale of the scheme. Some states with higher utilisation of those top medical and surgical packages are Kerala, Karnataka, Madhya Pradesh, Gujarat, Uttar Pradesh and Chhattisgarh, amongst others,” Sharma said.

The NHA head said that at AB PM-JAY, particular emphasis is given to making sure that beneficiaries can access services at any location, including their residence. 

“We’ve got empanelled a network of around 25,000 hospitals across the country. Of those, around 9,000 hospitals are in aspirational districts. Further, under AB PM-JAY, a ten per cent incentive is provided for all procedures carried out in hospitals situated in aspirational districts over and above the bottom package rates to encourage their participation,” he said.

There are 112 most under-developed districts across the country, and the federal government goals to quickly and effectively transform these districts to lift people’s living standards.

Under the scheme, a network of nearly 25,800 private and non-private hospitals has been developed, of which 10,700 are private healthcare facilities, whereas 15,100 are public healthcare establishments.

Many states have also relaxed the empanelment criteria in certain districts with inadequate health infrastructure to make sure an adequate variety of hospitals for the scheme beneficiaries.

“Because the scheme matures, it can assist in catalysing investment into healthcare infrastructure in under-served areas by fostering demand for healthcare services from the eligible beneficiaries,” he added.

He added that one could consider AB PM-JAY as an aggregator platform wherein healthcare providers can plug in to serve the needs of beneficiaries and earn a viable income.

Over 18 crore cards have been issued because the launch of the scheme in 2018 till May this 12 months. Based on the union health ministry, greater than 3 crore 20 lakh people have availed the good thing about hospital facilities, and hospital admission amount to 37 thousand 398 crore rupees till May this 12 months.

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