Ayushman Bharat Pradhan Mantri Jan Arogya (PMJAY) is developing standard protocols to improve quality of services, according to Indu Bhushan, CEO, PMJAY and National Health Authority (NHA).

He was speaking at Apollo Hospital’s International Health Dialogue here on Saturday.

“PMJAY will create large amount of data and with that we can study and understand different disease pattern, help improve and implement policies and support the health sector in general,” he said.

The agency is working with the Insurance Regulatory and Development Authority of India (IRDAI) to develop standards, empanel hospitals and create a format for claims management, he added.

The scheme had already provided a frame work for all the schemes to rally around. “At the national level there are several health schemes. Some are for weavers and fisherfolk. All those will merge with this PMJAY, which gives coverage to 540 million people,’’ the official said.

The scheme provides ecosystem for health insurance as the reach and depth of health insurance is limited, with just 10-15 per cent people under it before this scheme came in.

“We have to create an IT backbone, which will also help other schemes. It also standardises cost with power of bargaining on account of its volume. If an individual seeks services he has to accept the cost quoted, but here the costs come down not only on services, but also on devices, implants and all other inputs,” he added.

Reports released

NHA and IRDAI also released four reports prepared by their joint working group on hospital network management, data standardisation and exchange fraud and abuse control common in IT infrastructure for health insurance claim management.

“We are confident that implementation of these recommendations shall create a positive impact and lead to further growth of health insurance in the country,” Subhash Khuntia, Chairman, IRDAI, said.

comment COMMENT NOW