New Delhi: Amid the mounting pressure on corporate hospitals to empanel themselves under the government’s public health insurance scheme, Ayushman Bharat, industry body NATHEALTH said hospitals cannot join the scheme until it becomes viable for them.
While briefing the media at the 11th edition of NATHEALTH’s annual flagship summit, Abhay Soi, President, NATHEALTH and Chairman & Managing Director, Max Healthcare, said, “Most corporate hospitals are largely an urban phenomenon where the cost structure is slightly different, and until the Ayushman Bharat scheme becomes viable for them, they will be unable to participate.”
“In order to expand the scheme’s coverage, prices need to be increased to meet the minimum cost structure of private hospitals or, alternatively, reduce costs — particularly compliance costs related to infrastructure development — which can help bring down the cost per bed,” Soi added.
Ayushman Bharat, a flagship scheme of the Government of India, was launched as recommended by the National Health Policy 2017 to achieve the vision of Universal Health Coverage (UHC). This initiative has been designed to meet Sustainable Development Goals (SDGs).
According to the government, Ayushman Bharat PM-JAY is the world’s largest health assurance scheme, providing health coverage of Rs 5 lakh per family per year for secondary and tertiary care hospitalization to over 12 crore poor and vulnerable families — approximately 55 crore individuals.
In September 2024, the Union Cabinet further extended the scheme to include all senior citizens aged 70 and above, regardless of their income. This expansion is expected to benefit around 6 crore senior citizens across the country.
According to a release from the Ministry of Health and Family Welfare, as of September 9, 2024, over 35.4 crore Ayushman cards have been issued, and the government has provided more than ₹1 lakh crore (₹1,07,125 crore) in financial coverage for around 7.79 crore hospital admissions under the scheme.
During the monsoon session last year, Union Health Minister J.P. Nadda informed the Lok Sabha that as of June 2024, over 29,000 hospitals, including 12,625 private hospitals, have been empanelled under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY).
However, many leading corporate hospitals and healthcare chains have not empaneled their facilities in the scheme.
Responding to a query from ETHealthWorld regarding the rising stakes of Private Equity (PE) investors in Indian hospitals, Ameera Shah, Senior Vice President, NATHEALTH and Promoter & Executive Chairperson, Metropolis Healthcare, said, “Though private equity is a more expensive form of financing, it provides access to different kinds of loans, debts, and structured products at much lower rates, which may potentially make healthcare more viable and possibly more affordable.”
Adding to this, Om Manchanda, Treasurer, NATHEALTH and Managing Director, Dr Lal PathLabs, said, “Healthcare in India requires huge capital to build various assets, and any form of capital is always welcome to build infrastructure. At this point in time, that vacuum may be filled with private equity.”
