“Ayush­man Bharat Scheme to pro­vide op­por­tu­ni­ties for health­care pro­fes­sion­als”

BioSpectrum (Asia) - - Bio Event -

“The Ayush­man Bharat Scheme would pro­vide sig­nif­i­cant busi­ness op­por­tu­ni­ties for health­care pro­fes­sion­als in­clud­ing in­sur­ance com­pa­nies and Third Party Ad­min­is­tra­tors (TPAs),” said Dr Indu Bhushan, Chief Ex­ec­u­tive Of­fi­cer, Ayush­man Bharat.

Speak­ing at the Con­fed­er­a­tion of In­dian In­dus­try (CII) 12th Health In­sur­ance Sum­mit on ‘Ayush­man Bharat Na­tional Health Pro­tec­tion Mis­sion (AB-NHPM): Lever­ag­ing Op­por­tu­ni­ties for Health In­sur­ance Growth’ held in New Delhi on Au­gust 3, he said “pack­age rates have been de­ter­mined based on a thor­ough anal­y­sis and the scheme is de­signed to con­trol fraud and abuse, among oth­ers.”

He fur­ther said that presently 28 states are on board for inclusion in the Ayush­man Bharat Scheme while 8 states have yet to join. He said that at the na­tional level, all guide­lines cov­er­ing the scheme are in place and the IT back­bone has been pre­pared. Flex­i­bil­ity has been ac­corded to states with re­gard to cov­er­age, cost and the in­sur­ance model. Dr Bhushan said that no def­i­nite date has been de­cided for the launch of the scheme even as it would be stag­gered launch based on the pre­pared­ness of states.

Preeti Su­dan, Sec­re­tary, Depart­ment of Health, Min­istry of Health and Fam­ily Wel­fare, gov­ern­ment of In­dia stated that the Ayush­man Bharat Scheme un­der­pinned the ap­proach to­wards pro­vi­sion of uni­ver­sal health­care and rests on two pil­lars. The first pil­lar dwells on strength­en­ing the pri­vate health­care sys­tem and the se­condly it has­tens the move­ment from be­ing a health­care provider to a player in ter­tiary care sec­tor, in part­ner­ship with in­dus­try. Ac­cord­ingly, she strongly ad­vo­cated the need for build­ing cred­i­bil­ity in se­condary and ter­tiary health­care by creat­ing trans­par­ent sys­tems. In this con­text, she also sug­gested that the hos­pi­tals cre­ate a por­tal within its precincts on a vol­un­tary ba­sis to show­case their per­for­mance.

Reit­er­at­ing that the Ayush­man Bharat Scheme is poised to emerge as a game changer for the en­tire health­care in­dus­try, Dr Subash Chan­dra Khuntia, Chair­man, In­sur­ance Reg­u­la­tory Author­ity of In­dia (IRDA) of In­dia men­tioned that the scheme would de­crease cost, in­crease the ef­fi­ciency and ex­pand the cov­er­age of the health in­sur­ance sec­tor as the Scheme would in­clude the en­tire fam­ily in­stead of in­di­vid­u­als.

Ac­cord­ing to Dr Khuntia, with the in­crease in life ex­pectancy in the coun­try, the need for im­prov­ing in­sur­ance pen­e­tra­tion and cov­er­age was para­mount. The fo­cus should be to make the process on­line, en­hance use of tech­nol­ogy, in­crease aware­ness and un­der­stand­ing about the in­sur­ance prod­ucts, stan­dard­ise in­sur­ance prod­ucts and ra­tio­nal­ize ex­clu­sions. IRDA has also cre­ated a fraud repos­i­tory to pre­vent frauds, he said.

Dr Naresh Tre­han, Chair­man, CII Health­care Coun­cil and Managing Director, Medanta, the Medic­ity, while ex­tend­ing the com­mit­ment of in­dus­try to­wards the Ayush­man Bharat Scheme, sought more clar­ity on the op­er­a­tional­iza­tion of the scheme and the way in which the stake­hold­ers would be brought to­gether.

G. Srini­vasan, former CMD, The New In­dia As­sur­ance Co. Ltd, spoke about the po­ten­tial of the scheme and high­lighted a few chal­lenges such as paucity of health in­fra­struc­ture, lack of aware­ness, abuses in the sys­tem such as frauds, qual­ity of health­care, lack of trust and scarcity of funds.

L-R –Dig­ni­taries A Vaid­heesh, Chair­man, Sub-Com­mit­tee on Ac­ces­si­blil­ity; Health In­sur­ance &VP, South Asia & MD, In­dia, GSK; Dr Rana Me­hta, Part­ner and Leader Health­care Prac­tices, PWC; Dr Indu Bhushan, CEO, Ayush­man Bharat; Preeti Su­dan, Sec­re­tary, Depart­ment of Health, Min­istry of Health &Fam­ily Wel­fare, GoI; Dr Sub­hash Chan­dra Khuntia, Chair­man, IRDAI; Dr Naresh Tre­han, Chair­man, CII Health­care Coun­cil & Chair­man and MD, Medanta-The Medic­ity; G Srini­vasan, Former Chair­man & Managing Director, The New In­dia As­sur­ance Co. Ltd.; Neerja Bhat­tia, Ex­ec­u­tive Director, CII re­leas­ing a re­port “AB-NHPM -Pro­vid­ing Uni­ver­sal Health Cov­er­age to 500 mil­lion peo­ple” compiled by Price Water­house Coop­ers (PWC) at the 12th Health In­sur­ance Sum­mit.

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