“Ayushman Bharat Scheme to provide opportunities for healthcare professionals”
“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.