Not even 1 percent of the private hospitals expected to be empanelled to provide services under the Ayushman Bharat-National Health Protection Mission (AB-NHPM) carry a quality tag. This will make it difficult for the center’s flagship scheme, billed as the world’s largest health assurance program, to provide quality care. This is all the more so as the government is largely looking at the private sector for providing quality healthcare under the scheme, which is popularly known as Modicare and is set to be launched under the Pradhan Mantri Jan Arogya Yojana on 25 September, the birth anniversary of Bharatiya Jana Sangh leader Deendayal Upadhyaya. The health protection mission aims to cover more than 100 million poor and vulnerable families for secondary and tertiary care hospitalization in India where more than 70 percent of all health services are provided by the private sector.
At least 6000 private hospitals are likely to join the AB-NHPM but not all may not be accredited by the National Accreditation Board for Hospitals and Healthcare Providers (NABH), according to the Quality Council of India (QCI), an autonomous body aimed at ensuring that standards are maintained in various sectors including health. NABH is a constituent board of QCI, set up to establish and operate accreditation programs for healthcare organizations based upon international standards, through a process of self and external evaluation. “Currently, we have around 540 NABH-accredited hospitals in India which is a very small number. All these hospitals may not join Ayushman Bharat. NABH accreditation indicates that a hospital has best-in-class services and gives hospitals additional benefit as these hospitals will get more in the base rate in the scheme as compared to the non-accredited ones. It is totally a commercial decision and a private hospitals’ discretion to join or not to join the government scheme,” said Harish Nadkarni, chief executive officer, NABH.
“More and more NABH-accredited hospitals should join Ayushman Bharat because of the incentives. NABH-accredited hospitals will be paid 15 percent higher rate and entry level NABH hospitals will be paid 10 percent higher for the same package than non-accredited ones,” said Alok Saxena, joint secretary, ministry of health and family welfare. “We will try to ensure that we provide quality healthcare through private hospitals. Getting entry level accreditation from NABH is not very difficult and there should be around 2000 entry-level NABH hospitals, which is low. It is the just the starting of the scheme. If not immediately, gradually the quality healthcare systems under Ayushman Bharat will fall in place. We are empanelling hospitals according to their specialty and super-specialty such as cardio, neuro and nephro. Even before empanelment, the government will do reality checks of the hospitals if they have the required equipment and tools to provide quality healthcare,” he said.
At least 29 states and Union territories have started working on implementation of the scheme, according to the Union health ministry. Pilot projects have started in 16 Union territories, while other states will launch pilot projects before the launch of the scheme this month. Interestingly, the government will require an additional 160,000 hospital beds to provide health assurance under AB-NHPM, according to a PwC-Confederation of Indian Industry report. The ambitious scheme, to be implemented by the health ministry, aims to offer an annual health cover of ₹5 lakh per family, based on the socio-economic caste census (SECC) database. The health cover will allow beneficiaries to avail cashless treatment at any public or private empanelled hospital in India. The expenditure incurred in premium payment will be shared by the central and state governments. – Livemint