Question : Empanelment of Hospitals under Ayushman Bharat

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

(a) whether the Government has identified adequate number of hospitals under the scheme and completed their empanelment and if so, the details thereof along with the number of hospitals covered currently, State/UT-wise including Delhi/ NCR;

(b) whether the Government has achieved the target set under the Ayushman Bharat Yojana (ABY), if so, the details thereof, State/UT-wise;

(c) whether some States/UTs have not yet implemented the ABY, if so, the details thereof and the reasons therefor along with the number of States/UTs which have signed MoU to implement PMJAY and the number of States which have already launched the scheme;

(d) whether ABY provides paperless and cashless access to the beneficiaries during the service taken by them in empanelled hospitals, if so, the details thereof; and

(e) the details of the limitations and bottlenecks faced by the Government during the implementation of the ABY?

ANSWER
THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE
(SHRI ASHWINI KUMAR CHOUBEY)

(a) to (e): A statement is laid on the Table of the House



STATEMENT REFERRED TO IN REPLY TO LOK SABHA
STARRED QUESTION NO. 104* FOR 28TH JUNE, 2019

(a) & (b) Ayushman Bharat Yojana comprises two components namely (i) provision of Comprehensive Primary Healthcare through Ayushman Bharat – Health and Wellness Centers (AB-HWC); and (ii) Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY).
Under AB-PMJAY, all public hospitals (Community Health Centre and above), in the States implementing PMJAY, are deemed empanelled. Hospitals belonging to Employee State Insurance Corporation (ESIC) may also be empanelled based on the bed occupancy ratio parameter. All National institutes under Ministry of Health & Family Welfare as well as Institute of National Importance are part of the empanelled healthcare provider network for PMJAY. As far as private hospitals are concerned, they are empanelled by State Health Agencies of respective States. For empanelment, guidelines have been issued to all the States laying down the detailed criteria and process. Details of hospitals empanelled under AB-PMJAY State/UT- wise are at Annexure-I.
Facilities under AB-HWCs are available to all. The list of operational HWCs is at Annexure – II.
AB-PMJAY is an entitlement based scheme and it provides health coverage to around 10.74 crore poor and vulnerable families as per Socio Economic Caste Census data (approx. 50 crore beneficiaries).
(c) AB-HWC is being implemented in all States/ UTs except Union Territory of Delhi.
For implementation of AB-PMJAY, Memorandum of Understanding (MoU) has been signed with 33 States/UTs out of which 30 States/UTs have started its implementation. The States of Odisha, Telangana, and the Union Territory of Delhi have not signed the MoU for implementation of AB- PMJAY. The State Government of West Bengal has opted out of this scheme in January, 2019.
(d) Yes, PMJAY provides paperless and cashless treatment to the entitled beneficiaries in the empanelled hospitals. As on 25.06.2019, the total number of hospital admissions under PMJAY are 29,96,635 and claim amount is 4042.87 crore.


(e) PMJAY has gained positive momentum in a short period of time. Systems supporting the scheme proved effective. However, the issues that have been observed while implementing the scheme are: most of the entitled beneficiaries are poor & vulnerable and reaching out to them poses challenge; and capacity building of all stakeholders is a continuing exercise. Also, since PMJAY is implemented by the State Governments, the quality of implementation depends upon factors like involvement of State Governments and availability of infrastructure in the States etc.
The challenges in the implementation of AB-HWC are: ensuring adequate human resources at PHC-HWC; procurement and use of IT system to enable a system of digital records so as to improve appropriate referrals and continuum of care; ensuring uninterrupted supplies of medicines particularly for non-communicable diseases to respond to increasing footfalls; issues relating to governance and capacity, especially in the high focus states; and moving from delivery of services to mostly women and children to addressing adults including men, over thirty years of age for non-communicable disease screening, prevention, and management.