Union Minister of Health and Family Welfare, Jagat Prakash Nadda, reviewed the Pradhan Mantri Jan Arogya Yojana (PM-JAY) and Ayushman Bharat Digital Mission (ABDM) with senior officials of the National Health Authority (NHA) in New Delhi on Friday. This meeting aimed to evaluate the current progress and strategize for the further expansion and strengthening of these healthcare initiatives.
Detailed Presentation on Scheme Status
A comprehensive presentation was delivered by Deepti Gaur Mukherjee, CEO of NHA, detailing the key features, current status, and various operational aspects of the schemes. The presentation highlighted the significant milestones achieved, including 34.7 crore beneficiaries and 7.35 crore hospital admissions amounting to over Rs 1 lakh crore.
Strengthening Network of Empanelled Hospitals
NHA outlined a plan to enhance the network of empanelled hospitals and engage more effectively with them. This plan aligns with Prime Minister Narendra Modi’s vision of universal health coverage, aiming to benefit the most needy and vulnerable sections of society. The Health Minister emphasized the importance of ensuring that the benefits of these schemes reach the intended beneficiaries.
Addressing Implementation Challenges
Nadda directed officials to identify and resolve challenges hindering the effective implementation of PM-JAY. He stressed the need for regular engagement and coordination with state governments to understand and address issues comprehensively. The Minister highlighted the importance of a bottom-up approach, particularly in urban areas and metropolitan cities, to facilitate the creation of Ayushman cards for eligible beneficiaries.
Flexibility and Agility in Enrolment Process
To streamline the enrolment process, Nadda advised keeping the systems flexible and agile. He underscored the importance of creating pathways and mechanisms to verify eligible beneficiaries efficiently, ensuring they receive their Ayushman cards without hassle.
Leveraging Smart Technology for Beneficiary Feedback
Emphasizing the value of beneficiary feedback, Nadda suggested employing smart technology tools to connect directly with beneficiaries and gather their hospitalization and treatment experiences. This feedback will be instrumental in improving the delivery of healthcare services under PM-JAY and ABDM.
Fraud Detection and Prevention Measures
The Union Health Minister was briefed on the fraud detection and prevention measures implemented by NHA, which have significantly enhanced the efficiency of the schemes. These measures are crucial in maintaining the integrity and effectiveness of the healthcare programs.
Review of National Health Claims Exchange
Nadda also reviewed the National Health Claims Exchange (NHCX), developed by NHA in collaboration with the Insurance Regulatory Development Authority of India (IRDAI). NHCX facilitates the paperless settlement of claims submitted by hospitals to insurance companies. The platform provides IRDAI with a real-time dashboard view of claims settlement status. Currently, 33 insurance companies, covering 99% of the insurance market, are integrated into the NHCX platform. Additionally, citizens can check the status of their insurance claims through a mobile application.
Expanding Ayushman Bharat’s Reach
Nadda’s emphasis on a bottom-up approach highlights the need for grassroots-level interventions, particularly in urban and metropolitan regions where the complexity of verifying beneficiaries can pose significant challenges. By establishing clear pathways and robust verification mechanisms, the government aims to expedite the creation of Ayushman cards for eligible individuals. This initiative is expected to significantly expand the reach of Ayushman Bharat, ensuring that a larger population can benefit from the comprehensive healthcare coverage provided under PM-JAY.
Future Directions and Continued Commitment
Looking ahead, the Union Health Minister reiterated the government’s unwavering commitment to achieving universal health coverage. The ongoing efforts to refine and enhance the operational frameworks of PM-JAY and ABDM demonstrate a proactive approach towards addressing healthcare challenges in India. By continuously engaging with state governments, leveraging advanced technology, and implementing stringent fraud prevention measures, the government is poised to create a more resilient and efficient healthcare system. This sustained focus on improving healthcare accessibility and quality underscores the pivotal role of Ayushman Bharat in transforming India’s healthcare landscape.
The review meeting led by Union Health Minister Nadda underscored the government’s commitment to strengthening and expanding the Ayushman Bharat PM-JAY and ABDM initiatives. By addressing implementation challenges, leveraging technology for beneficiary feedback, and enhancing fraud prevention measures, the government aims to ensure that these visionary healthcare schemes effectively reach and benefit the most vulnerable sections of society.
Join TISHHA.
