‘Ayushman Bharat’ significant step towards universal health coverage in India: US think tank

Indias ambitious health insurance scheme, Ayushman Bharat, marks a significant step towards universal health coverage but the government should ensure that it is sustainable and delivers the high-quality care that Indians need, a top American think-tank said Friday. Based on the analysis of the first year of Pradhan Mantri – Jan Arogya Yojana (PM-JAY), popularly known as Modicare has put healthcare within reach for hundreds of millions, significantly increasing the number of people who have government-funded health insurance and far exceeding the initial estimates, Thats an impressive number, but theres still lots of work to do to bring down costs and bring up quality, Also read: Additionally, the researchers explain that embracing and improving access to primary care and linking it with the hospitalisation plan, rather than only providing hospitalisation, would go a long way toward promoting better health. The focus in the first year of Modicare has been on expanding access to health insurance, but at some point, the government needs to take steps to tackle the costs of the programme, the researchers said. These steps would include better purchasing policies for medical supplies and drugs and an increased focus on providing preventative health services like vaccines that could contain high costs of later treatment, they note. The next big step is making sure that that Modicare is sustainable and that it delivers the high-quality care that Indians need, In a country of almost 1.4 billion people that is home to one-third of global maternal deaths, where public spending for health accounts for roughly one percent of GDP and where 60 million people fall into poverty every year because of healthcare bills, fixing healthcare is a daunting task that will determine the worlds performance against the Sustainable Development Goals over the coming decade, said the report, a copy of which was made available exclusively to PTI. Noting that the scheme is by design pro-poor as it automatically provides entitlement to poor and vulnerable families identified based on Socio Economic Caste Census data, the report said PM-JAY is both benefiting from and triggering significant technological innovation, including the de novo development of a sophisticated IT system building on and improving existing platforms, such as the Transaction Management System of Telangana. The scheme is also developing a strong anti-fraud approach based on data analytics, the report said, adding that PM-JAY has developed real time dashboards to monitor the scheme. Centre for Global Development notes that massive data generated by PM-JAY can be used for not only improving implementation but also for policy inputs. The schemes dashboard can potentially offer a wealth of information to drive strategic purchasing and provider payment reform; inform clinical audit, thereby improving clinical governance and quality; and demonstrate impact on health and on spending, it said. India, it said, has kicked off a major tax-funded UHC reform with impressive early gains in covering the poor, providing hospital-based treatment, and generating efficiencies in claims processing that has enabled private participation in provision. Linking of PM-JAY with primary healthcare through Health and Wellness Centres and other mechanisms will be critical to create a continuum-of-care approach, it said.