Introduction of new system to measure hospitals performance

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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:

  1. Beneficiary satisfaction;
  2. Hospitalization rate;
  3. Limit on out-of-pocket expenditure (spending out of your pocket);
  4. Complaints filed and confirmed and
  5. 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

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