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Arogya Kosh Scheme: Delhi Govt Opens To Get Pvt Hospitals On Board

The Delhi government is set to increase package rates to be paid to private hospitals willing to be a part of the upgraded Delhi Arogya Kosh (DAK) scheme by 10%, after a section of hospitals said the money being offered was too low. This means the hospitals will now be paid up to 50% more than the rates offered under the Centre’s Ayushman Bharat scheme.

For instance, if a hospital would have received Rs 1 lakh from the Centre for a procedure covered under Ayushman Bharat, it will receive anywhere between Rs 1.1 lakh and Rs 1.5 lakh from the Delhi government if it decides to come under the DAK scheme. The money paid will depend on the hospital’s NABH accreditation and number of beds.

In a meeting held with Delhi Health Minister Satyendar Jain last month, representatives from several private hospitals are learnt to have expressed dissatisfaction over the rates offered by the government, which were already 10-40% above the Ayushman Bharat scheme.

There are around 1,100 private hospitals registered with the Delhi government in the city. Only 26 hospitals from Delhi have agreed to be part of the Centre’s Ayushman Bharat scheme so far.

“After a lot of deliberation, the meeting concluded with the decision that the government will raise the upper limit by 10% (to reach 50%). The Health Minister agreed to the suggestions made by private hospitals, but it was also made clear it cannot go beyond a certain point,” said Dr Arun Gupta, president of the Delhi Medical Council (DMC), who was present in the meeting.

Around 40 hospitals in Delhi have been empanelled so far. Under the new scheme, 1,016 surgical, 123 oncology and 10 neonatal procedures, as well as six medical packages, have been made part of 86 surgeries already covered under the DAK — a corpus that funds various health schemes for residents of Delhi. This includes implants as well as treatment for vector-borne diseases.

“The scheme is already implemented in some private hospitals and the government has entered into an agreement with around 40 of them,” Health Minister Jain told The Indian Express.

In order to incentivise timely payment, the empanelled hospitals shall provide a 3% discount on the total bill to DAK if payment is made within 15 days of submission of bill without any defect. Similarly, if payment is not made by DAK within 30 days of the bill submission, a penalty of 1% of the total bill will be added.

“We will also reimburse the cost of knee, hip and revision surgery provided it is performed in a Delhi government hospital having its own department of orthopaedics. The rates fixed by NPPA will be implemented,” said a senior official from the health department.

“Similarly, financial assistance will be provided to patients/hospitals for expenditure incurred in purchasing consumables like stent, pacemaker and aneurysm clip for patients who have a heart attack, stroke and arrhythmia,” said the official.-Indian Express

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