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Hope in troubled times: Ayushman Bharat and healthcare innovations in Madhya Pradesh

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Akash Tripathi, IAS, Secretary, Department of Health, Government of Madhya Pradesh highlights Ayushman bharat and healthcare innovations in Madhya Pradesh

The Government of India, in a landmark decision, launched the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana on September 23, 2018. This was launched as the world’s most ambitious government funded public health insurance (PHI) program. It was envisaged under the leadership of the Prime Minister, Narendra Modi, with a focus to provide free access to health insurance to the low-income group in the country.

This scheme has been delivering value and promise of health to an ever-increasing section of the target group, which roughly comprises the bottom 50% of the country in the socio-economic pyramid. The scheme promises all eligible beneficiaries with cashless and paperless healthcare benefits of up to Rs 5 lakh per family per year. As a result, it has empowered many disenfranchised sections of the society and has prevented them from falling prey to a vicious cycle of poverty and harassment for as basic a need as healthcare.

Since its inception, the scheme has been consistently bringing both private and public health facilities within its coverage network. Until now, the government has brought about 23,000 public and private empaneled hospitals within its ambit to provide health services to patients in 33 states and union territories of the country. As it stands, over 2 crore hospital admissions have been completed under this scheme, and about Rs 25,000 crores worth of treatment has been dispensed.[1]

As the scheme approaches the third anniversary of its successful launch and implementation, the Government of India has renewed its commitment to increase network coverage. Consequently, it is working on a war-footing to verify and enroll over 50 crore beneficiaries.[2]

Throughout the implementation of Ayushman Bharat Niramayam in Madhya Pradesh, the state has shown its commitment to the central government’s mandate by leading the tally in the verification and enrolment of eligible beneficiaries. In a coordinated effort with the state government, the State Health Agency identified beneficiaries of Sambal Yojna and the National Food Security Act cardholders to secure the list of poor families receiving the benefits under these schemes. This is in addition to the SECC beneficiaries’ families included by Central Government.[3] Madhya Pradesh has received national accolades for its intent and execution to include left-out poor families within the ambit of Ayushman Bharat.

Since inception of the scheme in Madhya Pradesh, State Health Agency has verified and enrolled over 2.5 crore beneficiaries to the Scheme, which is more than enrollment carried out in any other state or Union Territory.[4] It has also provided direct health benefits of over 9.3 lakh procedures, through an increasing network of 892 empaneled private and government hospitals. With the guaranteed insurance cover of Rs 5 lakh, the scheme provides coverage against 1,641 listed health packages under 23 specialties and has so far approved a claim amount of approximately Rs 1300 crore.[5]

In furtherance to our commitment to increase accessibility under the scheme, we are continuously training Lok Seva Kendras (LSKs), selected Gram Rozgar Sahayaks (GRSs) and Ayushman Mitras deployed in empaneled hospitals to make the Ayushman Bharat-PMJAY cards and further enroll one crore beneficiaries in next policy year. This focused intervention is primarily aimed to expedite beneficiary verification and enrollment, and to provide access to world-class healthcare to the ‘least of all.’

In the last year and a half, healthcare facilities across the world have suffered a major setback under the pressure of the COVID-19 pandemic. Despite the limitations posed by the pandemic, the state has successfully plowed through this unprecedented time having shown a matchless example of tough political will, and administrative efficiency. As a response to these limitations, we have brought in several innovations and policy interventions to ensure the provision of dedicated healthcare facilities to the citizens, even during the pandemic.

We would like to proudly emphasise that Madhya Pradesh State Government has been at the forefront during the COVID-19 pandemic to ensure quality health access to all its residents. To ensure people are provided COVID-19 treatment public health facilities were strengthened and upgraded as designated COVID treatment centers. In light of this unprecedented challenge posed by pandemic, Department in collaboration with private health facilities institutionalised dedicated COVID hospitals to provide cashless COVID-19 treatment.

Ayushman Bharat Niramayam under Mukhya Mantri COVID Upchar Yojna, May 2021, temporarily empaneled 311 private health institutions in addition to public sector hospitals and medical colleges to ensure quality COVID-19 treatment to Ayushman Bharat beneficiaries. During second COVID-19 wave, over 12500 beneficiaries were treated under the Yojana. Also, in wake of an increase in treatment and consumable costs, Madhya Pradesh Government revised COVID-19 package rates by 40 per cent in order to ensure qualitative healthcare is accessible to beneficiaries in quality health institutions.

Madhya Pradesh has been sure-footed in its journey to becoming the quintessential ‘Prerna Aur Pragati ka Pradesh’ by ensuring that ‘health for all’ does not remain a pipedream anymore but falls within the reach of each citizen of the state.






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