A healthcare platform has outlined measures ahead of the upcoming Union Budget, to increase the acceptability of the Ayushman Bharat health insurance scheme among more private healthcare providers.

Predictability in payments to hospitals for medical procedures undertaken by them under the health insurance scheme and support for fixed and variable costs incurred by these healthcare institutions in providing quality services to patients, for instance, are some of the recommendations made by the Nathealth Healthcare Federation of India, an industry representative told businessline.

Healthcare representatives expect the Centre’s health insurance scheme to get greater financial support in Budget 2024. In the past though, for reasons including pricing issues,  private healthcare providers have not entirely taken to the Centre’s scheme.

Nathealth’s submission to the Centre attempts to bridge this gap and encourage more private hospitals to get on board – by tapping into “under-utilised” capacities and paving the way for investments in new hospitals.  

Besides transparent digitally available information on the pricing of medical procedures and calculation of the support extended to hospitals on their fixed and variable costs, the industry-hand said, there needs to be a fixed commitment to making payments (for medical procedures undertaken) within a timeframe. Also, the payments should be on the pre-approved costs and should not be changed at the time of claims, the representative added.

Not “all or nothing” approach

Explaining how “under-utilised” capacities can be leveraged, the industry representative said, hospitals should be allowed to choose their healthcare services that can be included in the scheme, rather than have an “all or nothing” approach.

As the Centre looks to expand the health insurance scheme across more therapeutic segments and people (older age profile, missing middle class), the industry voice detailed measures to increase healthcare infrastructure.  

There needs to be a common registration for hospitals and a streamlining of compliance measures, the representative said, pointing to cumbersome procedures. A simple way to help existing hospitals expand is by altering building regulations to help them build upwards, rather than acquire more ground horizontally, the representative explained.

Health spends

Abhay Soi, President, Nathealth and Chairman and Managing Director, Max Healthcare Institute Limited, said in a statement, “As the nation progresses toward achieving a $5 trillion economy, providing quality healthcare for the entire population is a pre-requisite. Addressing healthcare challenges will require an estimated 2 billion square feet of advanced healthcare infrastructure. To meet these needs, increasing GDP spending on healthcare to 2.5 per cent is crucial for enhancing social insurance, expanding facilities in tier 2 and 3 cities, and advancing digital health services.”

Nathealth further called for rationalizing GST with a uniform 5 per cent rate slab for healthcare and full input tax credit eligibility, addressing the issue of unused MAT credits, and reviewing health-cess policies for MedTech to ensure affordability.