National Health Authority’s (NHA) IT infrastructure that supports the government’s flagship Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB – PMJAY), is probably one of the best in the world, Dr Vipul Aggarwal, Deputy Chief Executive Officer at AB – PMJAY, National Health Authority (NHA) said at the second edition of the Elets Digital Health Conclave.

“We are providing services through three core modules of the IT system: Hospital Empanelment Module, Beneficiary Identification System, and Transaction Management System. Over and above these three modules, we have portals for grievances, fraud controlling and monitoring. These are probably one of the best in the world; the fraud control framework provided by SAS, which is the biggest data analytics company,” Aggarwal informed.

Launched in 2018, AB – PMJAY is aimed at providing accessible and affordable healthcare to the common man. The world’s largest government-funded healthcare programme targets more than 50 crore beneficiaries. It provides a cover of up to Rs 5 lakhs per family a year for secondary and tertiary care hospitalisation. AB – PMJAY offers cashless and paperless access to services for the beneficiary at the point of service and help reduce catastrophic expenditure for hospitalizations, which impoverishes people. It helps to mitigate the financial risk arising out of catastrophic health episodes.

He added, “Under AB – PMJAY, the government enrolled or created cards for over 16 crore beneficiaries. It has provided treatment to 1.9 crore people and will soon reach the 2-crore mark. The government has spent over Rs 24, 000 crores in treatments; and general medicine and surgery are the top specialities being offered under the scheme. More than 20,000 hospitals, including 45% in the private sector are empanelled to provide the services. We have handled over Rs 500 crores worth of portability cases. Around 50% of the total benefit provided under the scheme is to females.”

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