Designing and rolling out a scheme that will benefit more than 50 crore people is a big challenge – Indu Bhushan ,CEO, Ayushman Bharat–National Health Protection Mission (Government of India)

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Designing and rolling out a scheme that will benefit more than 50 crore people is a big challenge – Indu Bhushan ,CEO, Ayushman Bharat–National Health Protection Mission (Government of India)

Medgate Today Magazine conducted an Exclusive Interview with Mr.Indu Bhushan,Chief Executive OfficerAyushman Bharat–National Health Protection Mission (Government of India)

You have huge experience in financing and implementing projects at the Asian Development Bank and you have a PhD and Masters in health economics from Johns Hopkins University. So, how will you use your background for implementing the world’s largest healthcare insurance scheme?

My international experience helps me in bringing lessons learnt from other countries to the scheme. We will seek to replicate the good practices from other countries and at the same time avoid the mistakes that were done by others. My international experience and education gave me an invaluable opportunity to work with world class experts, both Indian and international. I can also seek their help on how to better implement the scheme, especially when it is off the ground.

As a C.E.O of Ayushman Bharat the biggest health care protection programme, Its bit challenging assignment for you?

Yes, it is a challenging assignment. Designing and rolling out a scheme that will benefit more than 50 crore people is a big challenge. However, we have a highly motivated team and committed partners. We also have high level of political commitment, both at national as well as state levels. The challenge is to effectively channelize this commitment and energy for successfully implementing the scheme.

 Who all will be the beneficiaries’ of Ayushman Bharat and how they will avail these benefits? It will be cashless or on reimbursement basis?

The scheme will be cashless. No upfront payment needs to be made by beneficiaries. The beneficiaries of the scheme are selected from SECC database. This is the census done in 2011. The idea is to cover bottom 40 percent most deprived population in the country. We had done a validation drive in several states in last few weeks and have been able to identify about 80% of these beneficiaries in rural areas and about 60% in urban areas. We will send them a letter informing that they are eligible to avail of services. They can bring this letter or any other identification card to the hospital when they have to seek health care. Our IT system will recognise the beneficiary and issue an e-card which can be used for any follow up visit.

 How you will involve private  players/hospitals. What will be the criteria for empanelment?

We have clearly specified detailed criteria for empanelment (which is available on our website ABNHPM.GOV.IN). We have indicated the required level of human resources, infrastructure, equipment and services that need to be available for empanelment. States can modify these criteria, especially for lagging areas. We are keen to attract all quality hospitals to the scheme. If we assume that 2% of our targeted population will seek hospital care, we will have more than 1 crores persons benefiting from the scheme every year. This cannot be achieved unless we have a strong network of health facility both public and private. For attracting private hospitals, we will offer them reasonable rates and prompt payment of their claims. Any delay in payment to hospitals will attract penalty on insurance company or Trust.

What will be provider payment method? Is there will fix price for different diseases?

We have identified 1350 packages and their rates. The States have been given the flexibility to change the rates based on their context. The rates will include pre-hospitalisation and post hospitalisation benefits including all tests, medicines, services, food and staying charges.

As you have signed MOU with IMA for empanelment? What will be role of IMA?

IMA is an important body that represents large number of health care providers. We expect IMA to actively support the implementation of this ambitious scheme. We expect them to disseminate information about this scheme to its members and other people. We also want them to encourage the hospitals to empanel for Ayushman Bharat in a big way. We want all eligible high quality private hospitals to empanel. We expect IMA to provide regular feedback on the implementation of the scheme including how to make it sustainable and prevent cost escalation.

 

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