Ayushman Bharat - Hospitals' Concern

What is the issue?

Hospitals are displeased with the provisions of the Ayushman Bharat programme. Click here to know more on the scheme

What are the concerns?

• Rates - Government recently published the rates that insurance companies would pay hospitals.
• This applies for the 1,350 procedures covered under the scheme.
• Hospitals have criticised these rates as being arbitrary and low.
• E.g. the price of Caesarean section for 5 days of hospital stay, food and consultation is Rs.9,000
• Even government hospitals incur Rs.7,000 a day just to maintain a bed.
• Rationale - The reimbursement rates were not calculated in a scientific manner.
• Doctors are thus concerned about the clustering of medical conditions in the rate list.
• E.g. treatment for tuberculosis and HIV with complications will be reimbursed at the same rate of Rs.2,000 a day
• Clearly, the degree of treatments for HIV and tuberculosis differ.
• HIV complications can be relatively serious and these illnesses must be compensated differently in the scheme.
• Hospitals - Ayushman Bharat relied on a study of over 100 hospitals in 60 cities.
• But these were mostly hospitals with under 50 beds in tier-2 and tier-3 cities.
• The cost structure of these hospitals is substantially different from tertiary-care hospitals in tier-1 cities.
• But Ayushman Bharat rates do not account for these differences.

What is the government stand?

• For now, the government is committed to the launch date of August 15.
• But officials have acknowledged that the rates will be revised.
• AHPI (Association for Healthcare Providers India) has been asked to submit a list of 100 key procedures.
• Ayushman Bharat would then conduct a detailed cost study for this.
• Until then, hospitals are asked to continue with the present rates.

Source: The Hindu