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‘Target is to Achieve 2.5 Crores of Hospitalization End of the Calendar Year Under AB PM-JAY’

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Our target is to achieve 2.5 crores of hospitalization end of the calendar year under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), informed Dr Vipul Aggarwal, Deputy CEO, National Health Authority in an exclusive interaction with Prathiba Raju at the opening session of 10th Healthcare Leaders Forum.

Talking about the Pradhan Mantri Jan Arogya Yojana (PM-JAY) is the world’s biggest public-funded health insurance scheme and the hospital empanelments during the pandemic, Dr Vipul Aggarwal, Deputy CEO, National Health Authority (NHA), said, “We cater to the beneficiary base of 54 crore that is the bottom 40 percent of the population. At the time when the COVID-19 pandemic hit the country, we were having a 20,000 hospital base. Most of the government hospitals were getting converted into COVID-19 only facilities and many privates hospitals were closing down, a lot of hospitals were not working as people had fear of getting infected. On the beneficiaries’ side, there were a lot of issues and apprehensions. We wanted the private hospitals to join hands with us for two reasons, one is to keep them COVID-19 ready in case if the pandemic expands as a back-up arrangement. NHA started empaneling them more than the government hospitals.

The second reason was many elective procedures got delayed especially cancer related and kidney ailments which required time to time attention treatment got restricted. So we launched a new mechanism called Hospital Empanelment Module (HEM) Lite, patients suffering from serious illnesses, such as cancer, cardiac issues, and diabetes who required continuous treatment, were able to continue getting inpatient services without the fear of contracting the infection. In a short span of six months, we empanelled 5000 hospitals out of which 80 percent was from private hospitals. In this pandemic, there was a great response from private hospitals.”

Talking about one crore hospitalization, Aggarwal said, “If the pandemic did not hit us we could have achieved one crore hospitalization three or four months ahead of it. In September we achieved one crore hospitalization. We are targetting 2.5 crore end of the calendar year. We will be able to achieve this target as there has been more and more awareness by the state governments who are our partners, by our beneficiaries who are supporting and popularising the scheme at grass root levels. The treatment count and the coverage of the disease profile for the people have increased.”

Touching upon the special packages of COVID-19, Aggarwal said, “Ever since the pandemic hit us AB PM-JAY has treated around four lakhs patients, around 10 lakhs tests have been done we have spent 12 crores on total tests and treatment. In February, we had announced the COVID-19 testing and treatment packages where we had given the flexibility to the state government to decide on the premium over and above the base package. In medical packages, we have rates for hospital wards with or without ventilators. As health is a state subject NHA gave the state government the flexibility of choosing the packages so they can have an optimum premium.”

He also added that government agencies have put a collective effort to constrain this pandemic. Urged the public to follow the health and hygiene protocol.

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