Viswanath PillaMoneycontrol News
The Pradhan Mantri Jan Arogya Yojana (PMJAY) or Ayushman Bharat, the flagship government health scheme, is handling an average 5,000 claims per day.
So far, 6.85 lakh patients have been provided free hospital treatment under the scheme. Around 5.1 lakh claims have so far been processed under the scheme, for which payment has been released, while remaining claims are under process, according to the National Health Agency, the body that runs the scheme.
The scheme launched on September 23, 2018, completed 100 days on January 1.
The government expects the scheme to provide hospitalisation benefits to 25 lakh in the current fiscal year, and over 1 crore families to benefit in future.
Ayushman Bharat covers 10.74 crore poor families or 40 percent of India’s population. The weaker sections can avail a medical scheme covering hospitalisation charges spread over 1,350 hospitalisation packages for a sum of Rs 5 lakh per year for the whole family.
The weekly beneficiary identification has increased 10 times in 10 weeks since the launch of the scheme. So far, 75 percent of beneficiary verification has been done using Aadhaar identification.
In all 16,000 hospitals are currently empanelled by this scheme and include both government and private hospitals. Little more than 50 percent of the implementing hospitals, rapidly growing in numbers, is in the private sector. Around 65 percent of total admissions happened in private hospitals.
Cardiac, orthopaedics, urology and radiation oncology have emerged as top speciality segments where most patients under Ayushman Bharat were getting treatment.
The government is expecting the scheme to cost about Rs 4,000 crore, (including one-time investments on IT) and the states about Rs 1,600 crore in 2018-19. The expenses are shared between the Centre and state in the ration of 60:40. The government as of December has spent around Rs 900 crore.
Most of the states are also implementing the scheme under the trust model, where each individual state will form its own trust to manage the scheme and claims will be disbursed from a corpus created from the central and state government contributions.
The bulk of the beneficiaries are coming from states such as Tamil Nadu, Chhattisgarh, Gujarat, Karnataka and Maharashtra, that had prior experience of such schemes.
With the exception of Telangana, Odisha and Delhi, the rest of the states and union territories are on board to implement the scheme.