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Modicare covers basics, but complex healthcare mostly outside ambit

By Veena Mani
December 04, 2018 16:41 IST
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Among the most widely used packages have been treatment of cataract, dental root canal and normal delivery of babies.

Ilustration: Dominic Xavier/

Only a third of the hospitals empanelled under Ayushman Bharat or Modicare, billed as the biggest health care scheme, are accredited.

The latest data compiled by the government shows accredited and branded hospitals have, to a large extent, skipped the ambitious health care scheme, launched on September 25.


These are early days, an official tracking the numbers said, adding that despite the government offering additional benefits to accredited hospitals, their registration is low.

In fact, hospitals without any accreditation comprise 66 per cent of the total 22,000 empanelled hospitals nationwide.

Hospitals with the National Quality Assurance Programme of the World Health Organization and Joint Commission International make up for only 1 per cent each.

Around 11 per cent of the hospitals empanelled have the NABH (National Accreditation Board for Hospitals & Healthcare Providers) stamp. Also, private sector hospitals have mostly stayed away from Ayushman so far as  73 per cent of the hospitals empanelled for the scheme belong to the public sector.

With accredited hospitals resisting the Ayushman Bharat universe, the scheme has witnessed traction in general medical treatment much more than complex interventions, according to the data available for the two-month-old plan.

In a surprise finding, the numbers reveal that among the most widely used packages have been treatment of cataract, dental root canal and normal delivery of babies.

So far, 6,900 patients have got treatment for cataract, 4,900 went for root canal and 4,500 women underwent delivery in empanelled hospitals.

In comparison, there have been only 1,669 cases of cardiology and 686 cardio thoracic treatment; 1,222 patients for surgical oncology and only 488 for radiation.

A source explained that hospitals that dealt with more complex treatment like radiation in cancer cases had enrolled fewer in number than those focused on general medicine.

While more than 7,000 hospitals specialising in general surgery and medicine have enrolled, only a few hundred dealing with radiation, serious heart ailments and other complex categories are part of the Ayushman scheme.

Gujarat tops the list of states with the maximum number of claims.

More than 50,000 patients have availed the scheme from the state. Gujarat is followed by Tamil Nadu, Chhattisgarh, Kerala and Karnataka.

When the scheme crossed the 50-day mark recently, the government had announced that the number of beneficiaries had touched 200,000.

Since then, the number has increased with speed, officials pointed out.

Claims worth Rs 360 crore have been submitted already, they said.

Ayushman Bharat aims to provide tertiary health care of up to Rs 500,000 for 500 million people.

While the scheme will provide healthcare for those listed in the socio-economic caste census, states are also adding beneficiaries below the poverty threshold. For these BPL beneficiaries, the states will bear the premium.

For the current 2018-19 financial year, the health ministry has projected a total expenditure of Rs 6,000 crore, of which 60 per cent will come from the Centre and 40 per cent from the states.

The Union Budget presented in February 2018 had allocated Rs 2,000 crore for the project.

In the coming years, the total cost could possibly go up to Rs 12,000 crore annually, according to projected estimates.

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Veena Mani in New Delhi
Source: source