Ayushman Bharat completes 2 years with 1.26 crore treatments worth Rs.15500 crore

arogya manthan

Ayushman Bharat – the Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) completing two year of its launch has provided more than 1.26 crore treatments worth Rs.15500 crore benefitting crores of Indians, informed Union Minister for Health and Family Welfare, Dr Harsh Vardhan.

Union health minister inaugurated Arogya Manthan 2.0, a 4-day international conference and workshop organised by the National Health Authority (NHA) and delivering the keynote address said, “Healthcare in today’s time must be looked at through multiple considerations. Technology must be leveraged well to meet citizens’ healthcare needs. Nowhere is it better demonstrated than Ayushman Bharat PM-JAY which has made technology its backbone to drive access to timely and affordable healthcare through 1.26 crore treatments worth Rs.15500 crore through its fast expanding network of over 23,000 public and private empanelled hospitals.”

Congratulating the 32 State and UT Governments for their committed partnership and NHA for reaching out to the poorest and most vulnerable citizens in the country, he said, “Healthcare is a basic human right. PMJAY has given the entire country confidence that health is available to everyone, even if they do not have a single penny, all they need is an E-card to avail treatment.”

He further informed that one crore successful treatments were made in over 23,000 public and private hospitals. Special volunteers were deployed to help the public irrespective of their status, to get easy access to treatment by showing the digital ID.

Currently the scheme is implemented in 32 States and Union Territories, PM-JAY has enabled in-patient healthcare services with an authorised amount of over Rs.16,000 crore. More than 23,300 hospitals have empanelled under the scheme. Gujarat, Tamil Nadu, Chhattisgarh, Kerala, and Rajasthan have emerged as the top performing states providing the highest number of treatments.

AB-PMJAY, provides health insurance cover of Rs. 5,00,000 to more than 53 crore poor and vulnerable citizens, achieved a landmark of 1 crore (10 million) hospitalisations in less than 20 months in May this year.

Highlighting the significance and immediate need to build the necessary network and infrastructure for universal health coverage, Dr. Harsh Vardhan said, “The need of the hour is to make ourselves and our country Aatma nirbhar. The need is not only to model and adapt technologies of the future to achieve our development goals, but also to build our own capabilities and those of other stakeholders through impactful partnerships, collaborations and networks.”

Also read: Around 3,000 fraud cases worth Rs 4.5 crore detected under Ayushman Bharat

Reflecting and assessing the two years journey of PMJAY, Dr. Indu Bhushan, Chief Executive Officer AB PMJAY and NHA said, “Today, as we mark the two years Ayushman Bharat PM-JAY, world’s largest publicly funded health assurance scheme, has achieved several milestones, including 1 crore hospital admissions in May this year. This was achieved in less than 20 months since the launch of the scheme. With PM-JAY, India has taken a giant leap towards providing accessible and affordable healthcare to the common person. I am pleased to report that 1.26 crore hospital admissions, worth Rs 15,772 crores have been provided through a network of 23,311 hospitals across 32 States and UTs. The scheme has generated a savings of approx. Rs. 30,000 crores to its beneficiaries. 1,25,454 hospital admissions have been authorized in non-patient States/UTs under portability of services. Kerala leads in the country with 6549 hospital admissions per lakh beneficiary population while with approximately 8.1 beds available per thousand beneficiary population, Goa leads the country. However, among the larger states, Karnataka and J & K are the leaders. We also got the opportunity to support the Government of India’s Covid-19 response through leveraging our call centre in running the national Covid helpline 1075 and providing free testing and treatment under PM-JAY. So far, 3.35 lakh tests and 31,500 treatments have been provided to the beneficiaries.”

Speaking about technology and innovation implemented in the scheme, Dr. Indu Bhushan said, “In recognition of its contribution to digital transformation of health service delivery through PMJAY, NHA was awarded “National Gold Award for e-Governance 2019-2020” for its IT system which is a digital marvel in the healthcare sector. Seven of the best healthcare startups in the country were awarded as the winners of Ayushman Bharat PM-JAY Startup Grand Challenge which was launched as an open platform to source the most promising innovations that can help solve some of our key implementation challenges and will be provided end-to-end scale-up support through our newly launched Market Access Program. Innovation is seen in the Start-up Grand Challenge and the launch of National Health Digital Mission has modernized the scheme.”

Union Health Minister, Dr Harsh Vardhan presented the awards to the winners of the Ayushman Bharat PM JAY Startup Grand Challenge and launched the Market Access Program of NHA. Unveiled the electronic Ayushman Bharat PM-JAY Coffee Table Book (Volume 2), a collection of 100 photo stories of beneficiaries from across the States and UTs. A compilation of all the implementation challenges and learnings from the last year.

In addition to the above, Dr. Harsh Vardhan launched the AB PM-JAY Joint Certification Programme to develop the skills and knowledge of relevant stakeholders for accurate and efficient processing of claims and prevention and detection of fraud and abuse. This certification is jointly supported by the National Health Authority and the Insurance Institute of India (III) and developed by experts from NHA, III and the World Bank.

Given the zero tolerance policy towards fraud in AB PM-JAY, the Minister also released the, “AB PM-JAY Anti-Fraud Framework: Practitioners’ Guidebook” which will serve as a useful tool for the states as in one place it provides the anti-fraud guidelines, techniques, advisories along with legal remedies/course of action presently available under applicable Indian laws. This Guidebook will serve as an excellent instrument for capacity building for the State Health Agencies to take effective measures for prevention, detection and deterrence of fraud under AB PM-JAY.

Elucidating about the implementation of the ambitious National Digital Health Mission (NDHM) Bhushan said, “NHA is entrusted with the design and roll-out of the NDHM under the supervision of the Ministry of Health. NDHM aims to develop the necessary backbone to support the unified digital health infrastructure of the country. It will bridge the existing gap amongst different stakeholders of the healthcare ecosystem through digital highways and increase access of citizens to healthcare.

Launched on 23rd September 2018 from Ranchi by Prime Minister, Narendra Modi, PM-JAY has provided 1.26 crore cashless secondary and tertiary level treatments to citizens

Achievements of Ayushman Bharat PM-JAY in two years

  • 32 States and UT implemented the scheme.
  • 1.26 crore hospital treatments (52% provided by private hospitals)
  • 23,311 hospitals empaneled (45% private)
  • 12.6 crore e-cards issued
  • Rs 15,579 Crore Value treatments provided
  • 1,25,454 portability cases
  • 63 lakh calls answered by NHA Call centre (14555)
  • 2 crore users on
  • 20 lakh PM- JAY mobile app installs
  • Savings of approx. Rs. 30,000 crore
  • Top 5 Tertiary Specialties by Preauth Requested Amount
  • Orthopaedics
  • Cardiology
  • Radiation Oncology
  • Neo-natal
  • Medical Oncology
  • Top 5 Tertiary Procedures by Preauth Requested Amount
  • PTCA – single stent (medicated, inclusive of diagnostic angiogram)
  • PTCA – double stent (medicated, inclusive of diagnostic angiogram)
  • Linear Accelerator External Beam Radiotherapy IGRT (Image Guided radiotherapy) (Radical/Adjuvant/Neoadjuvent)
  • Total Knee Replacement
  • Intensive Neonatal Care Package

Top States in Hospital Admissions (Proportion of pre-authorisations per lakh population)

  • 6,549 – Kerala
  • 5,938 – Daman & Diu
  • 5,479 – Goa
  • 5,410 – Gujarat
  • 4,472 – Mizoram
  • 3,784 – Chhattisgarh
  • 2,915 – Jammu & Kashmir
  • Top States with beds empanelled (Beds in Empaneled Hospitals per 1000 population)
  • 8.1 – Goa
  • 7.5 – Sikkim
  • 6.8 – Lakshadweep
  • 6.2 – A&N Islands & Chandigarh
  • 5.7 – Himachal Pradesh
  • 5.7 – Karnataka
  • 4.6 – Jammu and Kashmir

Response to COVID-19

  • Scaling of hospital network: HEM lite – 147 hospitals empanelled.
  • Health Benefit Packages: Packages for COVID-19 treatment, testing, sample transportation and PPE kits
  • 1075 National COVID-19 Helpline
  • Cleansing and verification of the COVID-19 patients data shared by ICMR
  • Triaging & Tele-consultation Based on Arogya Setu Data
  • Out-bound calling to High-risk Beneficiaries of PM-JAY
  • Development of dashboards for tracking
  • Policy brief of the evidence on utilization trends of PM-JAY under lockdown

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