INSUBCONTINENT EXCLUSIVE:
flagship insurance programme Ayushman Bharat Scheme because quality care to patients at current rates is unviable.
Five national private
hospitals ET spoke to said that government should have taken their inputs before deciding the package costs that the Niti Ayog announced in
government is expected to give insurance cover to a vast majority of Indians.
Niti Ayog announced a detailed list of rates for 1,354
packages for 23 treatments across various therapies and procedures
This scheme is expected to provide insurance cover of Rs 5 lakh per family for up to 10 crore Indians below the poverty line
The policy covers hospitalisation, treatment expenses including for secondary and tertiary level of medical and surgical care
patients do not end up getting substandard care.
Habib Khorakiwala of Wockhardt Hospitals said he was unsure if large hospitals would
participate in this scheme
private hospitals have stayed away from state insurance schemes for lack of profitability
The Ayushman Bharat scheme held out hope with the Rs 5 lakh cover a balance could be struck between profitability and affordable
soon.
Under the scheme the cost of pulmonary artery double stenting is capped at Rs 65,000, a bypass surgery with synthetic graft at Rs
90,000, a cementless hip replacement at Rs 90,000 and knee replacement at Rs 80,000
The package rates are nearly 20% less than the treatment package covered under the Central Government Insurance schemes and state schemes
like Rajiv Gandhi Bima Yojana
Analysts say this is where the industry is miffed because it expected comparable to better than similar earlier schemes.
Many private
providers treat state scheme patients profitably onthe back of a cost-effective delivery model in areas like consumables, drugs, implants
(HCG), which specialises in cancer care, has decided his hospital will be unable to treat the patients under this scheme at these
rates are decided nationally
We have given states some flexibility to change the rates
