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Viable delivery system needed for quality healthcare: NATHEALTH

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Development of quality, accessible health service packages an important step towards UHC with support from private providers

On World Health Day, healthcare industry body-NATHEALTH reinforced its commitment to create viable delivery ecosystem which would provide further impetus to the goal of Universal Health Coverage (UHC). Terming Ayushman Bharat- Pradhan Mantri Jan AarogyaYojna (AB-PMJAY) as a game changing scheme, NATHEALTH focuses on appropriate, safe and sustainable delivery of healthcare services to beneficiaries, along with quality assurance.

“AB / PMJAY is a unique and game changing universal healthcare scheme which is the largest state-run health insurance cover. NATHEALTH has been engaging with the government to come up with a broader participation of this scheme by the private sector especially in the underserved areas and is working on ways and means of getting this done, “said Dr H SudarshanBallal, President, NATHEALTH and Chairman, Manipal Hospitals.

The provision of Rs. 5 lakh per family per year for medical reimbursement, under PMJAY is expected to go a long way to achieve the goals of UHC and as a multi-segment collaborative platform NATHEALTH has extended all technical and expert support to the government for the successful implementation of the programme.

“Along with higher public and private spending in the Indian healthcare sector, there is urgent need to put in place a rational pricing mechanism for treatments under PMJAY so that the target population are able to access quality healthcare in an affordable manner and insurers (both public and private) find it sustainable from their business point of view,” said Dr Arvind Lal, Past President, NATHEALTH and Managing Director, Lal PathLabs.

Presently, a very small percentage of the population in the country are covered under some form of health insurance. Out- of -pocket expenses are very high at around 60 per cent and the new scheme is expected to meet the most critical requirement of healthcare.

“For private providers, viability is the key. Hence, positive role of states would be decisive in making the scheme a grand success. Companies need an adequate pricing pattern to sustain in the long term. Going forward, there should be scope for revision and improvement on aspects like success metrics, premium payment terms and standardisation of treatments,” said Gautam Khanna, NATHEALTH Governing Council Member and CEO, PD Hinduja Hospitals.

The development of quality and accessible health service packages is an important step towards the goal of UHCwith support from private providers.
“With the well-being of the last mile beneficiary as the sector’s focus, the government is also looking forward to active and sustained contributions of NATHEALTH towards improvement of quality of health care and increasing investment in health infrastructure in the country,” said Siddhartha Bhattacharya, Secretary General, NATHEALTH.

“In a recent meeting with National Health Authority officials, we assured them full support. We will provide technical experts and inputs, whenever required by the authority. The exercise of calibrating package rates and the development of standard treatment protocols is expected to begin soon and is a very important step towards a sustainable collaboration that will drive the goal of health to all,” added Dr Ballal.

Healthcare leaders were of the view that for UHC all stakeholders need to move forward in a collaborative spirit. Building a strong delivery network, with wide participation by the private sector, is very critical for successful implementation of Ayushman Bharat.

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