Specialized treatment tops health insurance scheme Ayushman Bharat-PM-JAY – The New Indian Express

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Express press service

NEW DELHI: Chemotherapy, neonatal procedures, minimally invasive surgeries to open blocked coronary arteries or (PTCA), heart failure and surgeries to remove kidney stones are the top five procedures used in the past year by beneficiaries of the Ayushman Bharat-PM-JAY Health Insurance Scheme.

“People have experienced the benefits of AB PM-JAY for the treatment of various diseases, especially the conditions which constitute the highest disease burden and economic hardship due to the healthcare costs incurred,” said RS Sharma, chief executive of the National Health Authority (NHA). .

The scheme, billed as the largest government-funded public health insurance scheme in the world, aims to provide 50 million beneficiaries with health coverage of Rs 5 lakh per family per year for secondary and tertiary care hospitalizations in private and public hospitals.

As deaths and cases of cancer are rising rapidly in India, the main draw for ordinary people to take advantage of the cashless and paperless insurance scheme is chemotherapy. Nearly 7 lakh chemotherapy procedures have been carried out at tertiary care centers under the government’s ambitious flagship program. The second most sought after procedure is for neonatal care procedures. About 1.7 lakh have been made.

PTCA surgeries, which help improve blood flow to the heart muscle without open-heart surgery, were the third most important medical procedure performed at the various licensed tertiary health care centers under the program.

The fourth procedure that beneficiaries benefit from is congestive heart failure or heart failure procedures, which can sometimes be life-threatening if proper and immediate medical treatment is not provided on time. Around 41,000 such medical treatments have been provided to people who otherwise would not have been able to access such expensive health care.

Percutaneous nephrolithotomy (PCNL), a technique used to remove specific stones in the kidney or upper ureter, was the fifth surgery – more than 35,000 – that has been performed by people in the past year.

Sharma also said procedures for cardiology, oncology, kidney disease and general medicine, which cover secondary and tertiary care, are among the best packages.

He added that other health programs that are among the most used procedures include cataract surgery, cesarean delivery for high-risk pregnant women, severe anemia and enteric fever or typhoid fever.

The total value of hospitalizations allowed for major medical and surgical procedures in the previous year is around Rs. 4,126 crore in secondary and tertiary care.

In 2021-2022, a total of 1.52 crore hospital admissions were cleared under AB PM-JAY. The total value of these hospital admissions stands at around Rs. 14,957 crores till May 25 this year, Sharma told this newspaper.

“Our goal is to increase the reach and scale of the program. Some states that are using these best medical and surgical packages more are Kerala, Karnataka, Madhya Pradesh, Gujarat, Uttar Pradesh and Chhattisgarh among others,” Sharma said.

The head of the NHA said that at AB PM-JAY, special emphasis is placed on ensuring that beneficiaries can access services at any location, including their residence.

“We have built a network of about 25,000 hospitals across the country. Of these, about 9,000 hospitals are in aspirational districts. In addition, under AB PM-JAY, a 10% incentive is provided for all procedures performed at hospitals in aspirational districts beyond the base package rates to encourage their participation,” he said. -he declares.

There are 112 most underdeveloped districts across the country, and the government aims to quickly and effectively transform these districts to raise the living standards of the people.

As part of this system, a network of nearly 25,800 public and private hospitals has been developed, including 10,700 private health establishments and 15,100 public health establishments.

Many states have also relaxed integration criteria in certain districts with inadequate health infrastructure to ensure sufficient hospitals for program beneficiaries.

“As the program matures, it will help catalyze investments in health infrastructure in underserved areas by stimulating demand for health services from eligible beneficiaries,” he said. added.

He added that AB PM-JAY could be seen as an aggregation platform where healthcare providers can connect to meet the needs of beneficiaries and earn a viable income.

Over 18 crore cards have been issued since the launch of the program in 2018 until May this year. According to the Union Health Ministry, more than 3 crore 20 lakh people have availed the hospital facilities and the amount of hospital admissions stands at Rs 37,000 398 crore till May this year.

NEW DELHI: Chemotherapy, neonatal procedures, minimally invasive surgeries to open blocked coronary arteries or (PTCA), heart failure and surgeries to remove kidney stones are the top five procedures used in the past year by beneficiaries of the Ayushman Bharat-PM-JAY Health Insurance Scheme. “People have experienced the benefits of AB PM-JAY for the treatment of various diseases, especially the conditions which constitute the highest disease burden and economic hardship due to the healthcare costs incurred,” said RS Sharma, chief executive of the National Health Authority (NHA). . The scheme, billed as the largest government-funded public health insurance scheme in the world, aims to provide 50 million beneficiaries with health coverage of Rs 5 lakh per family per year for secondary and tertiary care hospitalizations in private and public hospitals. As deaths and cases of cancer are rising rapidly in India, the main draw for ordinary people to take advantage of the cashless and paperless insurance scheme is chemotherapy. Nearly 7 lakh chemotherapy procedures have been carried out at tertiary care centers under the government’s ambitious flagship program. The second most sought after procedure is for neonatal care procedures. About 1.7 lakh have been made. PTCA surgeries, which help improve blood flow to the heart muscle without open-heart surgery, were the third most important medical procedure performed at the various licensed tertiary health care centers under the program. The fourth procedure that beneficiaries benefit from is congestive heart failure or heart failure procedures, which can sometimes be life-threatening if proper and immediate medical treatment is not provided on time. Around 41,000 such medical treatments have been provided to people who otherwise would not have been able to access such expensive health care. Percutaneous nephrolithotomy (PCNL), a technique used to remove specific stones in the kidney or upper ureter, was the fifth surgery – more than 35,000 – that has been performed by people in the past year. Sharma also said procedures for cardiology, oncology, kidney disease and general medicine, which cover secondary and tertiary care, are among the best packages. He added that other health programs that are among the most used procedures include cataract surgery, cesarean delivery for high-risk pregnant women, severe anemia and enteric fever or typhoid fever. The total value of hospitalizations allowed for major medical and surgical procedures in the previous year is around Rs. 4,126 crore in secondary and tertiary care. In 2021-2022, a total of 1.52 crore hospital admissions were cleared under AB PM-JAY. The total value of these hospital admissions stands at around Rs. 14,957 crores till May 25 this year, Sharma told this newspaper. “Our goal is to increase the reach and scale of the program. Some states that are using these best medical and surgical packages more are Kerala, Karnataka, Madhya Pradesh, Gujarat, Uttar Pradesh and Chhattisgarh among others,” Sharma said. The head of the NHA said that at AB PM-JAY, special emphasis is placed on ensuring that beneficiaries can access services at any location, including their residence. “We have built a network of about 25,000 hospitals across the country. Of these, about 9,000 hospitals are in aspirational districts. In addition, under AB PM-JAY, a 10% incentive is provided for all procedures performed at hospitals in aspirational districts beyond the base package rates to encourage their participation,” he said. -he declares. There are 112 most underdeveloped districts across the country, and the government aims to quickly and effectively transform these districts to raise the living standards of the people. As part of this system, a network of nearly 25,800 public and private hospitals has been developed, including 10,700 private health establishments and 15,100 public health establishments. Many states have also relaxed integration criteria in certain districts with inadequate health infrastructure to ensure sufficient hospitals for program beneficiaries. “As the program matures, it will help catalyze investments in health infrastructure in underserved areas by stimulating demand for health services from eligible beneficiaries,” he said. added. He added that AB PM-JAY could be seen as an aggregation platform where healthcare providers can connect to meet the needs of beneficiaries and earn a viable income. Over 18 crore cards have been issued since the launch of the program in 2018 until May this year. According to the Union Health Ministry, more than 3 crore 20 lakh people have availed the hospital facilities and the amount of hospital admissions stands at Rs 37,000 398 crore till May this year.

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