An Overview:
The Indian government has expanded the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) to provide health coverage for all citizens aged 70 and above, with Rs 5 lakh per year in benefits. This move aims to ease medical expenses for seniors, but industry leaders have raised concerns about timely payments and adequate reimbursement rates for hospitals, especially smaller and medium-sized facilities that may face challenges in managing the increased patient load.
Challenges for Smaller Hospitals
Dr. Harsh Mahajan, Chair of FICCI Health Services Committee, highlighted that expanding the scheme could strain smaller hospitals, as senior citizens often require more intensive care. Timely reimbursements are crucial to maintaining the quality of healthcare services.
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Need for Fair Reimbursement Rates
Dr. Girdhar Gyani, Director General of the Association of Healthcare Providers (AHPI), emphasized that fair reimbursement rates and timely payments are essential for the scheme’s success. Without these, smaller hospitals could struggle to continue participating, potentially affecting healthcare availability for the elderly.
India’s Growing Elderly Population
With India’s senior population expected to rise sharply, public health experts support the expansion of AB-PMJAY, citing the increasing healthcare needs of the elderly. As per UN estimates, the population aged 65 and above in India is projected to grow from 104 million in 2024 to 246 million by 2050.
Geriatric Care Packages and Financial Support
The government plans to introduce more geriatric care packages under the scheme and launch awareness campaigns to ensure smooth enrollment. The financial outlay of Rs 3,437 crore for the expansion will be allocated over 18 months, covering the remaining six months of this financial year and the next full year.
For Expert Support in Navigating AB-PMJAY and Ensuring Compliance
Operon Strategist supports healthcare providers with regulatory compliance and turnkey project management. For expert guidance on navigating schemes like AB-PMJAY, contact Operon Strategist today.
