News
One in three PM-JAY hospitals inactive since scheme’s launch
Summary
The largest number of inactive hospitals are in Andhra Pradesh (1,232 inactive out of 2,659 hospitals), followed by Rajasthan (932 out of 1,372). Tamil Nadu has 731 inactive hospitals out of 2,573, and UP has 297 inactive hospitals among 3,519.New Delhi: Over a third of hospitals empanelled under Ayushman Bharat are inactive, official data showed, in a worrying trend for the world’s largest health insurance scheme aiming for universal health coverage.
Out of 27,000 hospitals empanelled for Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) since its 2018 launch, only 18,783 remain active, the latest health ministry data showed. Among the rest, 4,682 hospitals have been inactive since the beginning, having never catered to a single PM-JAY beneficiary. Further, 3,632 hospitals tur-ned inactive in last six months, taking the total number of inactive hospitals to 8,314.
Mint has reviewed the data, which is updated daily.
PMJAY offers free health cover of up to ₹5 lakh to over 107.4 million poor and vulnerable families (about 500 million beneficiaries), with free and cashless treatment through a network of private (15,000) and government (12,000) empanelled hospitals across the country. National Health Authority (NHA) is implementing and executing the scheme under the Union health ministry.
“In the recent past, several attempts have been made to state health authorities (SHAs) to turn hospitals active within their jurisdiction. However, if any hospital fails to raise even a single pre-authorization wit-hin six months from its empanelment, NHA has made stringent guidelines to de-empanel such hospitals," a person aware of the matter said on condition of anonymity.
The level of inactivity varies from state to state. The largest number of inactive hospitals are in Andhra Pradesh (1,232 inactive out of 2,659 hospitals), followed by Rajasthan (932 out of 1,372). Tamil Nadu has 731 inactive hospitals out of 2,573, and UP has 297 inactive hospitals among 3,519.
Queries sent to the ministry and an NHA spokesperson remained unanswered till press time.
A second person aware of the matter said on condition of anonymity, “There could be multiple reasons for the inactiveness of the hospitals. There are many hospitals which might not feel like participating. The price package for medical services might not be to their expectations, or the payments may not be on time." Another reason could be that there were many hospitals which do not have appropriate in-patient facilities as in the past. This issue was highlighted in Karnataka, where primary health centres (PHC) were joined under PM-JAY. PHCs do not have the capacity for secondary and tertiary care hospitalization.
NHA is not at fault, rather it is SHAs who need to see and strengthen active hospital participation and look after timely release of payments to hospitals, the second person said.
This year, PM-JAY is celebrating its fifth anniversary. So far, it has achieved more than 54 million authorized hospital admissions and created 240 million Ayushman cards, which entitle the beneficiary to free healthcare services.
Top tertiary care specialities under which beneficiaries have utilized treatments include medical oncology (cancer treatment), emergency care, orthopaedics and urology.
