Crisil has started the ball rolling in the area of accreditation of hospitals in the country. Having assigned healthcare grades to hospitals in Delhi and Chennai, the rating agency has given grade A to the first Mumbai-based hospital, Bombay Hospital and Medical Research Center.
The rating agency is evaluating 12 more hospitals since it launched the healthcare grade product a couple of months ago.
According to Roopa Kudva, executive director and chief rating officer, Crisil, "While it is not mandatory for healthcare establishments to be graded, these gradings will help insurance companies and third-party administrators in shortlisting hospitals as a part of their respective networks". The industry has been asking for some form of standardisation and accreditation of hospitals.
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Crisil has defined benchmarks for grading hospitals and evaluates them based on facilities, equipment, manpower and service quality levels.
All the hospitals graded to date by the rating agency have been assigned grade A, which indicates consistency with the highest standards in the Indian healthcare industry. The grading structure defines the minimum level of equipment installed, the number of surgeries undertaken, among other benchmarks.
The Insurance Regulatory and Development Authority (Irda) proposes to lay down standards for hospitals and come out with an accreditation system for healthcare outfits. This will be undertaken in consultation with the Health Ministry as it falls under its purview, and not that of the insurance regulator. The idea behind an accreditation and standardisation system is to check hospitals from overcharging patients, and thereby bring down the high claims ratio.
The industry is asking for is a standard fee structure to be laid down. In the absence of any government standardisation levels, billings in healthcare establishments vary and are not necessarily in keeping with any minimum hospital facility requirement. Crisil's grading structure, however, does not comment on the cost or affordability of a hospital or healthcare establishment, said Kudva.
Forty per cent of hospitals have two different billings for patients. For those who admit to having insurance cover, bills are inflated by 40 to 50 per cent and in some cases even 120 per cent, said George Mathew M, managing director, Ican Medicare.