Specialised therapy tops Ayushman Bharat-PM-JAY medical insurance scheme

Express News Service

NEW DELHI: Chemotherapy, neonatal procedures, minimal invasive surgical procedures to open blocked coronary arteries or (PTCA), coronary heart failure and surgical procedures to take away kidney stones are the highest 5 procedures availed within the final one 12 months by the beneficiaries of the Ayushman Bharat-PM-JAY medical insurance scheme. 

“People have availed benefits under AB PM-JAY for treatment of various diseases, particularly the ailments which constitute the highest disease burden and economic hardship due to incurring healthcare expenditures,” R S Sharma, the National Health Authority (NHA) Chief Executive Officer, stated.

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

As Cancer deaths and circumstances are growing quickly in India, the highest draw for the frequent folks availing the cashless and paperless insurance coverage scheme is chemotherapy. Nearly 7 lakh chemotherapy procedures have been carried out at tertiary care centres underneath the formidable flagship authorities programme. The second most sought-after process is neonatal care procedures. Around 1.7 lakh have been carried out.

PTCA surgical procedures, which assist in bettering blood move to the center muscle with out open-heart surgical procedure, have been the third highest medical process carried out on the numerous tertiary healthcare centres which have been authorised underneath the scheme.

The fourth process that’s availed by the beneficiaries is congestive coronary heart failure or coronary heart failure procedures, which may typically be life-threatening if correct and quick medical therapy isn’t offered in time. About 41,000 such medical therapies had been offered to individuals who couldn’t have in any other case been capable of entry and afford such expensive healthcare.

Percutaneous Nephrolithotomy (PCNL), a way used to take away particular stones within the kidney or higher ureter, was the fifth most surgical procedure – over 35,000 – that was availed by folks within the final 12 months.

Sharma additionally stated the procedures related to cardiology, oncology, renal ailments, and common drugs, which cowl secondary and tertiary care, are a number of the prime packages.

He added that the opposite well being packages which characteristic among the many prime utilised procedures embrace cataract surgical procedure, caesarean supply for high-risk pregnant girls, extreme anaemia and enteric fever or typhoid fever.

The complete worth of authorised hospital admissions for the highest medical and surgical interventions throughout the earlier 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 underneath AB PM-JAY. The complete worth of such hospital admissions involves about Rs. 14,957 crores until May 25 this 12 months, Sharma informed this newspaper.

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

The NHA head stated that at AB PM-JAY, specific emphasis is given to making sure that beneficiaries can entry providers at any location, together with their residence. 

“We have empanelled a network of around 25,000 hospitals across the country. Of these, around 9,000 hospitals are in aspirational districts. Further, under AB PM-JAY, a 10 per cent incentive is provided for all procedures carried out in hospitals located in aspirational districts over and above the base package rates to encourage their participation,” he stated.

There are 112 most under-developed districts throughout the nation, and the federal government goals to shortly and successfully rework these districts to lift folks’s dwelling requirements.

Under the scheme, a community of practically 25,800 private and non-private hospitals has been developed, of which 10,700 are personal healthcare amenities, whereas 15,100 are public healthcare institutions.

Many states have additionally relaxed the empanelment standards in sure districts with insufficient well being infrastructure to make sure an enough variety of hospitals for the scheme beneficiaries.

“As the scheme matures, it will help 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 may consider AB PM-JAY as an aggregator platform whereby healthcare suppliers can plug in to serve the wants of beneficiaries and earn a viable earnings.

Over 18 crore playing cards have been issued because the launch of the scheme in 2018 until May this 12 months. According to the union well being ministry, greater than 3 crore 20 lakh folks have availed the good thing about hospital amenities, and hospital admission quantity to 37 thousand 398 crore rupees until May this 12 months.

NEW DELHI: Chemotherapy, neonatal procedures, minimal invasive surgical procedures to open blocked coronary arteries or (PTCA), coronary heart failure and surgical procedures to take away kidney stones are the highest 5 procedures availed within the final one 12 months by the beneficiaries of the Ayushman Bharat-PM-JAY medical insurance scheme. 

“People have availed benefits under AB PM-JAY for treatment of various diseases, particularly the ailments which constitute the highest disease burden and economic hardship due to incurring healthcare expenditures,” R S Sharma, the National Health Authority (NHA) Chief Executive Officer, stated.

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

As Cancer deaths and circumstances are growing quickly in India, the highest draw for the frequent folks availing the cashless and paperless insurance coverage scheme is chemotherapy. Nearly 7 lakh chemotherapy procedures have been carried out at tertiary care centres underneath the formidable flagship authorities programme. The second most sought-after process is neonatal care procedures. Around 1.7 lakh have been carried out.

PTCA surgical procedures, which assist in bettering blood move to the center muscle with out open-heart surgical procedure, have been the third highest medical process carried out on the numerous tertiary healthcare centres which have been authorised underneath the scheme.

The fourth process that’s availed by the beneficiaries is congestive coronary heart failure or coronary heart failure procedures, which may typically be life-threatening if correct and quick medical therapy isn’t offered in time. About 41,000 such medical therapies had been offered to individuals who couldn’t have in any other case been capable of entry and afford such expensive healthcare.

Percutaneous Nephrolithotomy (PCNL), a way used to take away particular stones within the kidney or higher ureter, was the fifth most surgical procedure – over 35,000 – that was availed by folks within the final 12 months.

Sharma additionally stated the procedures related to cardiology, oncology, renal ailments, and common drugs, which cowl secondary and tertiary care, are a number of the prime packages.

He added that the opposite well being packages which characteristic among the many prime utilised procedures embrace cataract surgical procedure, caesarean supply for high-risk pregnant girls, extreme anaemia and enteric fever or typhoid fever.

The complete worth of authorised hospital admissions for the highest medical and surgical interventions throughout the earlier 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 underneath AB PM-JAY. The complete worth of such hospital admissions involves about Rs. 14,957 crores until May 25 this 12 months, Sharma informed this newspaper.

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

The NHA head stated that at AB PM-JAY, specific emphasis is given to making sure that beneficiaries can entry providers at any location, together with their residence. 

“We have empanelled a network of around 25,000 hospitals across the country. Of these, around 9,000 hospitals are in aspirational districts. Further, under AB PM-JAY, a 10 per cent incentive is provided for all procedures carried out in hospitals located in aspirational districts over and above the base package rates to encourage their participation,” he stated.

There are 112 most under-developed districts throughout the nation, and the federal government goals to shortly and successfully rework these districts to lift folks’s dwelling requirements.

Under the scheme, a community of practically 25,800 private and non-private hospitals has been developed, of which 10,700 are personal healthcare amenities, whereas 15,100 are public healthcare institutions.

Many states have additionally relaxed the empanelment standards in sure districts with insufficient well being infrastructure to make sure an enough variety of hospitals for the scheme beneficiaries.

“As the scheme matures, it will help 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 may consider AB PM-JAY as an aggregator platform whereby healthcare suppliers can plug in to serve the wants of beneficiaries and earn a viable earnings.

Over 18 crore playing cards have been issued because the launch of the scheme in 2018 until May this 12 months. According to the union well being ministry, greater than 3 crore 20 lakh folks have availed the good thing about hospital amenities, and hospital admission quantity to 37 thousand 398 crore rupees until May this 12 months.