Treatment costs under Ayushman Bharat health scheme to be revised

The central government’s flagship health scheme, Ayushman Bharat, will see more changes as a team is working on rationalising package rates. 

The government started the process of revising rates after hospitals said these rates wouldn’t be viable. 

While surgeries cost lakhs of rupees outside the scheme, under Ayushman Bharat they cost a few multiples of Rs 10,000. 

There was a meeting of senior officials on revising the rates of packages. 

Till April 3 this year, close to 3 million beneficiaries received their cards and 1.8 million beneficiaries availed of services under the scheme. 

Over 15,000 hospitals have been empanelled by the government, a thousand more hospitals than in November. 

Private hospitals in India have been expressing their displeasure with the package rates in the scheme.

Senior officials say the number of procedures in the scheme might be brought down.

A senior government source said: “We have found some procedures are overlapping with those of other health programmes. These include C-section deliveries and cataract operations. Those can be covered under those schemes instead of beneficiaries receiving treatment under Ayushman Bharat.” 

Apart from this, the government is working on revising the rates of procedures. While a few procedures will be removed, the government plans to add others.

Experts suggest removing some packages could be detrimental to hospitals’ interests because the Ayushman Bharat scheme offers better rates for such schemes.

Meanwhile, the government is working on creating standard treatment protocols so that treatment under the scheme is of good quality. 

The Budget provided Rs 6,400 crore for Ayushman Bharat, for which where the state pays 40 per cent of the premium and the Centre 60 per cent.

The scheme will provide tertiary care to those who feature in the Socio-Economic Caste Census 2011. Each beneficiary gets treatment worth up to Rs 500,000. Officials said 100 million families were eligible for the scheme.

The scheme covers 1,354 medical and surgical packages under 25 specialties. The benefits include hospitalisation expenses in the general ward; consultation fees; equipment and procedure charges; the cost of consumables and tests; food for patients; and pre- and post-hospitalisation. 

The Ayushman Bharat scheme was rolled out by scrapping the Rashtriya Swasthya Bima Yojana. RSBY provided medical cover up to Rs 30,000. Earlier, the government had planned an insurance of up to Rs 100,000, but that was revised and the Ayushman Bharat scheme was launched.