Introduction of new system to measure hospitals’ performance
Recently National Health Authority (NHAI) has introduced a new system to grade the performance of hospitals under Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB – PMJAY)
- Under this new initiative, the concept of ‘value-based care’ will be introduced. Under this, payment will be made on the basis of performance (result).
- Also, service providers will be rewarded according to the quality of treatment provided by them.
- The new initiative aims to measure the performance of hospitals under AB-PMJAY on the basis of value of health care services rather than volume of health care services.
- The performance of the hospitals will be made available on a public dashboard. This will help the beneficiaries in the selection of the hospital.
Importance of value based care
- The demand for quality treatment will increase.
- The services patients are receiving will result in better health outcomes and greater satisfaction.
- Healthcare providers will be rewarded and incentivized to focus more on providing patient-centric services.
- This will lead to a significant improvement in the health care service scenario in India.
The performance of empaneled hospitals will be measured on the basis of five performance indicators:
- Beneficiary satisfaction;
- Hospitalization rate;
- Limit on out-of-pocket expenditure (spending out of your pocket);
- Complaints filed and confirmed and
- Improvement in the health-related quality of life of the patient.
Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)
- Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) was launched by the Prime Minister on September 23, 2018 in Ranchi, Jharkhand.
- Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) provides a cover of up to Rs 5 lakh per family per year for secondary and tertiary care hospitalization.
- More than 10.74 crore vulnerable eligible families (about 50 crore beneficiaries) are eligible for these benefits.
- Benefits under AB-PMJAY are portable across the country.
- There is no restriction on family size, or age or gender.
- AB-PMJAY is fully funded by the government and the cost is shared between the central and state governments as per the extant instructions issued by the Ministry of Finance.
- Beneficiary households under AB-PMJAY have been identified from the Socio Economic Caste Census (SECC) of 2011 on the basis of selective deprivation and occupational criteria in rural and urban areas.
Source – PIB