Health Minister to Industry Bigwigs

In a move to bring private hospitals on board to join the Narendra Modi government’s flagship Ayushman Bharat scheme, the ministry of health is planning to link treatment rates with the wholesale price index (WPI), has learnt.

The planned move was discussed by union health minister Mansukh Mandaviya in a meeting with big names from the healthcare industry on Thursday.

Ayushman Bharat, touted as the world’s largest health insurance scheme, is formally known as Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY).

Notable attendees

The meeting was attended by top government officials including Dr VK Paul (member, health, Niti Aayog), RS Sharma (CEO of National Health Authority), Rajesh Bhushan (secretary, ministry of health), and other officials.

“The minister shared a new concept that may resolve the pricing issues related to the slower adoption of Ayushman Bharat by the private hospitals,” said Girdhar J Gyani, director-general of Association of Healthcare Providers of India (AHPI), the lobby of private hospitals. “Overall, it was a fruitful meeting. The minister showed determination to realise the goal of achieving universal health coverage across the country.”

The AHPI represents 2,500 super-specialty and 8,000 smaller hospitals across India.

“He suggested that procedure rates can be linked with the WPI and the rates will increase in relation to the WPI, similar to the pharmaceutical industry,” Gyani said, while applauding the idea.

Annual hikes in the prices of drugs in the National List of Essential Medicines is based on the wholesale price index. WPI is used as the base to revise the prices of these drugs. The move would mean that the price list of treatment packages will be annually revised in accordance with the hike in WPI.

For instance, if WPI rose by 10%, the price of treatment packages such as angioplasty or double valve replacement will also go up by 10%.

The meeting was attended by top industry officials including Naresh Trehan from Medanta, Dr Ashutosh Raghuvanshi (CEO, Fortis), Dr Harsh Mahajan from Mahajan Imaging, and Dr Arvind Lal (managing director of Dr Lal PathLabs) apart from other top players.

Reconsider business strategies: Govt to industry

The minister asked the industry to join Ayushman Bharat to serve the beneficiaries who require super-speciality treatments.

“The aim is clear. They want to bring more and more private hospitals on board. The idea is to expand the bouquet of treatment procedures that can be offered to beneficiaries. Those who are looking for critical procedures should have multiple options,” said an official representing top hospitals at the meeting.

Moreover, the industry – which is facing a pendency of payments of over Rs 600 crore used by CGHS – was assured that the payment for procedures under the Ayushman Bharat scheme will be released within 45 days of submission of claims.

Moreover, the officials also discussed plans to merge all the government schemes such as Employee State Insurance Scheme (ESIC), Central Government Health Scheme (CGHS), Ex-Servicemen Contributory Health Scheme (ECHS), etc, on a common platform.

The government’s top officials told the industry to take a fresh look at their business strategies with the objective of achieving high volumes and low costs.

“For instance, the automobile industry re-looked at its business strategies and made the processes efficient to bring down the costs. The officials advised us to reconsider our business models,” Gyani from AHPI said.

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