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Kerala Private Hospitals Warm up to Modicare

Private hospitals in Kerala that had threatened to withdraw from the state and central government health insurance schemes are now eager to be empaneled hospitals under the Ayushman Bharat-National Health Protection Scheme (AB-NHPS). This is despite the fact that many of the procedures offered under Ayushman Bharat scheme are almost 20-25 percent lesser than even Central Government Health Scheme (CGHS), which the private hospitals claimed is much lesser than the actual cost incurred by the hospitals. “All small hospitals are eager to welcome Ayushman Bharat scheme in Kerala as we have been promised timely payment. We are forced to wait longer for payment under schemes like RSBY and even CGHS,” said Farhaan Yasin, secretary, Kerala Private Hospital Association (KPHA). At present there are around 200 empaneled private hospitals in the state that cater to patients under various government schemes such as Karunya, SnehasparshamRashtriya Swasthya Bima Yojana, ESI, ECHS and CGHS. Most of these hospitals are eager to be part of Ayushman Bharat.

Around 10-20 percent patients who visit these hospitals are covered under the schemes. “The scheme is of great benefit for patients as the coverage is ₹5 lakh per family, while the current maximum coverage under state health insurance schemes is ₹2.5 lakh,” said Dr Harish Pillai, CEO, Aster Hospitals and Clinics, India said “This comprehensive insurance scheme will benefit the BPL a lot. Now, we don’t have a comprehensive health scheme in the state where the people have the choice of opting for either a government or empaneled private hospital,” said Dr Sanjeev Singh, medical superintendent, Amrita Institute of Medical Sciences. Private hospitals will have to re-engineer their current business model to be part of the highly subsidized packages under the scheme. “When the patient knows that the government is going to pay for them, they can choose whether to go to a government or empaneled private hospital,” added Dr Pillai. – TOI