Pune private hospitals not interested to join MPJAY, PMJAY schemes

While the Maharashtra government is trying to motivate more private hospitals in the city to join the central government’s flagship health scheme Ayushman Bharat (PMJAY) and the state-run Mahatma Jyotiba Phule Jan Arogya Yojana (MPJAY), several hospitals are reluctant to get empanelled under the schemes due to low package rates.

The state government last year revamped the MPJAY scheme, making it universal and increasing the medical treatment cover from the earlier ₹1.5 lakh to ₹5 lakh. Under the PMJAY scheme, beneficiaries are provided coverage of up to ₹5 lakh per family per year. Following this, the authorities are trying to motivate more private hospitals in the city to join the schemes.

Several prominent private hospitals in the city have also received letters requesting them to get empanelled under the schemes. The issue was discussed during a meeting of the Association of Hospitals in Pune (AHP) wherein the hospitals claimed that the package rates are too low and not financially feasible. The package rates are old and have not been revised for the past four years, they said.

Dr H K Sale, executive director of Noble Hospital and president of the AHP, said that hospitals are not interested in getting empanelled due to the low package rates. “It’s been a while since we have been requesting the government to revise the rates. If the rates are revised, hospitals will be happy to get empanelled. Given the low rates, there are hardly any big private hospitals that have got empanelled under the scheme,” Dr Sale said.

In Pune district, there are 68 hospitals empanelled under the MPJAY and PMJAY schemes. Out of the 68 hospitals, 53 are private and 13 are government hospitals. A majority of the 53 private hospitals that are empanelled under these schemes are small hospitals. There is a need to get big hospitals on board as small hospitals cannot provide tertiary care treatment.

Dr Behram Khodaji, chief executive officer, Ruby Hall Clinic, said that both the schemes are good and they had approached the authorities in the past regarding empanelment.

“The package rates need to be revised and the process to get empanelled is also tedious and should be simplified. In some treatment specialties, the rates are better but in other specialties, the rates are very poor. There should be uniformity in the rate packages,” Dr Khodaji said.

Dr Vinod Sawantwadkar, chief executive officer, Jehangir Hospital, said that there has to be a collaborative approach to run such schemes and the government should discuss the issue with the private hospitals. “The decision should be taken after discussion with the hospitals. The government can discuss with the hospitals to find a solution. Hospitals have their problems and expenses are incurred to run them. It becomes difficult to start schemes that have low packages when hospitals are already running other health schemes,” Dr Sawantwadkar said.

Whereas Dr Amol Mhaske, regional head of MPJAY and PMJAY schemes, said that the rates offered under the schemes are low but the government has revised the rates for some packages. “The government is in the process of appointing a new insurance firm for the scheme. Once the new firm is appointed, the revised rates and procedures will be effective,” Dr Mhaske said. Hindustan Times