Modicare Beneficiaries can Soon Access Best Cancer Care from Network of Specialists

Ayushman Bharat beneficiaries will soon be able to seek the best advice from a network of cancer specialists digitally linked across the country, and won’t have to travel long distances to consult an expert. The National Health Authority is in talks to partner with the National Cancer Grid which runs a “virtual tumor board” from Mumbai’s Tata Memorial Hospital. The board that works through the grid, a digital network linking hospitals, deals with complex cancer cases and can make the best treatment options available to Ayushman beneficiaries. The proposal, once implemented, will also make up for the absence of similar multi-disciplinary oncology teams in some healthcare institutions, officials said. Oncologists estimate that about a quarter of cancers diagnosed each year in India might be labelled “complex cases”, where treatment is not obvious or straightforward. “We are expecting to sign an agreement with the National Cancer Grid within 2-3 weeks. This will not only improve accessibility, but will also help us develop standard treatment protocols and guidelines for all type of cancers,” Ayushman Bharat deputy CEO Dinesh Arora said.

Cancer accounts for over 30 percent of the total tertiary cases treated under the Pradhan Mantri Jan Arogya Yojana (PMJAY) — the health insurance arm of the government’s flagship Ayushman Bharat program, official data shows. The government has earmarked around Rs 400 crore for cancer care under the scheme. However, the low share of cancer hospitals in the network, along with a weak portability mechanism due to many states opting to remain out of the scheme, often poses a challenge for beneficiaries to access care. Currently, there are 1,574 hospitals with cancer treatment facilities empaneled under the scheme. Of this, merely 438 are hospitals that offer multi-modal treatment facilities, including chemotherapy and radiation. Five states — Gujarat, Uttar Pradesh, Karnataka, Tamil Nadu, and Chhattisgarh — account for the majority share of 76 percent empaneled cancer hospitals, catering to most beneficiaries from across the country. Officials say early trends also show substantial patient movement across states to access cancer care. Still, the share of portability is high only in Gujarat, which received 23 percent of patients from outside the state for cancer treatment. Next to Gujarat is Bihar with 10 percent portability share, receiving patients from Jharkhand.

Data shows that there have been around 2.20 lakh hospital admissions seeking cancer care under PMJAY so far. Of this, close to 1,53,000 were medical oncology cases, whereas radiation oncology accounted for 44,479 cases. Rest were surgical and pediatric oncology. With the rising incidence of cancer, officials expect the demand for cancer care to increase exponentially. “Partnering with the National Grid will enable vetting of treatment plans from across the country by the board to ensure that patients across the country are receiving the best advice,” Arora said, adding there is an urgent need to ramp up infrastructure to meet the rising demand for cancer treatment. PMJAY aims to provide an annual health cover of Rs 5 lakh to around 50 crore beneficiaries in around 10.74 crore families. So far, 16.82 lakh hospital admissions have been recorded under the scheme. Of this, 30 percent are tertiary care cases accounting for 75 percent of the over Rs 2,200 crore authorized for hospital admissions. – TOI