Delays in payment to healthcare providers, and low tariffs for medical procedures are some of the potential challenges that have been flagged by doctors from across Delhi in the implementation of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), the central government’s flagship healthcare scheme, in the Capital.
The concern has been raised ahead of the signing of an MoU between the Delhi government and the Centre on April 10 to implement the scheme in the national capital. The scheme’s implementation was among BJP’s key poll promises in its manifesto for the Assembly polls. A group of doctors from the Delhi Medical Association (DMA) met Chief Minister and Health Minister Dr Pankaj Singh on Friday where the issue of the delay in payment to the healthcare providers was discussed at length. The group of doctors said that payments to health care organisations (HCOs) are long delayed under the scheme. It should be done in a time-bound manner, they said.
The doctors also discussed the issue of tariffs under the scheme, saying that these were too low for a place like Delhi.
“These will be unsustainable by our healthcare providers because of high infrastructure costs and manpower,” said the delegation during its meeting. Dr Alok Bhandari, president, Delhi Medical Association, said the delegation requested for a joint committee to sort out the issues. “One size cannot fit all. The Ayushman Bharat has to be modified to be implemented in Delhi. There are adverse experiences in many places where payments have been delayed. Payment should be commensurate with the services expected…,” he said, adding that in the meeting with the CM and Health Minister, the delegation requested to discuss the scheme before giving blanket orders and rolling the scheme out.
DMA has over 20,000 doctors associated with it from private hospitals, nursing homes, and government hospitals across Delhi. It also requested a structured onboarding framework to facilitate wider adoption and ensure that many patients benefit from the scheme. It said that the process for empanelment and reimbursement needs streamlining, ensuring timely payments and reduced procedural burdens for hospitals. It has also proposed setting up a joint working group between the Health Department and representatives of private healthcare establishments to ensure the successful implementation of Ayushman Bharat.
The newly-formed BJP government plans to enroll at least one lakh beneficiaries under the scheme within 30 days as part of its 100-day agenda. The scheme aims to provide annual health coverage of Rs 5 lakh per family.
Under the scheme, an estimated 6.54 lakh of the poorest families in Delhi will receive health coverage up to Rs 5 lakh. Moreover, 4.5 lakh families with people over the age of 70 — some of whom may already be eligible for cover as per their economic status — are also likely to benefit.