Over 2,000 Covid-19 patients under Ayushman Bharat cover

Maitri Porecha New Delhi | Updated on May 21, 2020 Published on May 20, 2020

As on date, up to 2,132 Covid-19 patients admitted in hospitals are seeking care under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY).

Seven States/UTs — Chhattisgarh, Chandigarh, Jharkhand, Kerala, Meghalaya, Mizoram and Uttar Pradesh — have adopted Covid testing and treatment packages charted out under the scheme. “Most treatment for Covid-19 is occurring under government set-ups; other States are in the process of getting ready,” said Indu Bhushan, CEO, National Health Authority (NHA), which implements AB PM-JAY.

Bhushan said that over 3,000 persons have been tested under the scheme apart from those hospitalised, of which 4-5 per cent have tested positive. It is not necessary that all those who were tested were hospitalised, or all who were hospitalised were tested under the scheme.

To rope in private hospitals

“We provide free testing and hospitalisation under the scheme primarily in private hospitals; in public hospitals, testing and hospitalisation are offered for free by the governments in any case. Our aim is to rope in private hospitals to get ready for a potential case surge — for keeping hospitals, beds and financing mechanisms ready,” said Bhushan.

Currently, 499 Covid-only private hospitals and 439 Covid-only public hospitals are under AB PM-JAY. All private hospitals reporting Severe Acute Respiratory Infection (SARI) cases are being called and informed about the provision of Covid-19 testing under the scheme. On April 13, the Indian Council of Medical Research (ICMR) made testing of all SARI cases for Covid-19 compulsory.

The challenge for the AB PM-JAY scheme is two-fold — for treating Covid-19 and non-Covid-19 patients. Until April 1, close to 35,000 non-Covid patients were getting hospitalised every day under the scheme. This registered an over 50 per cent drop to hover at 10,000-15,000 patients during the lockdown period. Top non Covid-19 treatments for which patients seek care under the scheme include total knee replacement, fractured hip implant, implanting heart stents, cancer treatment and kidney treatment including dialysis.

“Non-Covid-19 treatment, especially critical care, has been slower in the past couple of months. Private hospitals are refusing patients and treatment during the lockdown and they have to scale back-up,” said Bhushan.

Express empanelment

Currently, 21,565 hospitals have been empanelled under the scheme, of which 9,500 are private. “To bring more hospitals on board to continue providing critical care during the lockdown...and to prevent the risk of cross-infection, NHA has launched express empanelment,” said Bhushan.

“The criteria for temporary empanelment of hospitals under Ayushman Bharat PM-JAY were prepared. These are less stringent than those for permanent empanelment. This mechanism helps in empanelling dedicated Covid-19 hospitals as well. More than 1,385 additional hospitals have been empaneled across the country since April 1 till date through regular and express empanelment mechanisms. Out of these, 75 hospitals have been added through the new express empanelment mechanism,” he added.

The scheme is also empanelling private labs registered with the ICMR for Covid-19 testing.

Launched in September 2018, AB PM-JAY, which provides an annual treatment cover of ₹5 lakh each for poor families, has till date completed up to one crore treatments. This includes a spending of ₹13,412 crore for hospital admissions by insurance providers, the Centre and States in one-and-a-half since its launch.

Published on May 20, 2020

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