NITI Aayog and NHA reassure FICCI’s health sector leadership on sustainable partnerships for Ayushman Bharat

A delegation comprising key members of the FICCI Health Services Committee recently met senior officials of NITI Aayog and the National Health Authority (NHA) to discuss the way forward for effective engagement of the private healthcare providers for continued success of the government’s flagship healthcare programme- Ayushman Bharat.

FICCI presented its policy recommendations on the key tenets for implementation of Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), including scientific costing of medical procedures, sustainable pricing in healthcare, expansion of healthcare infrastructure in tier II and III cities and strategies for strengthening the number of specialist doctors in the country.

Dr Rajiv Kumar, Vice-Chairman, NITI Aayog, highlighted that the government envisions private healthcare providers as key partners for AB-PMJAY and appreciated the scale of expansion and expertise of private healthcare providers, catering to more than 70 per cent of healthcare demands of the country.

Dr V K Paul, Member (Health), NITI Aayog, reassured the industry members that several key developments on AB-PMJAY were underway, taking cues from the various recommendations made by FICCI on healthcare human resources, healthcare infrastructure expansion and rational reimbursement rates.

Discussing the FICCI costing study- Demystifying Healthcare Costs, Brig Dr Arvind Lal, Chair- FICCI Health Services Committee and CMD, Dr Lal PathLabs said, “It is very important to devise a scientific framework for determination of cost incurred in delivering care and to define differential reimbursement rates for healthcare providers.” The FICCI costing study used Time-Driven Activity-Based Costing (TDABC) to derive actual cost incurred by providers for delivery of select medical procedure. TDABC has been accepted internationally and recommended by experts like Robert Kaplan and Michael Porter in the Harvard Business Review as the most scientific method of arriving at costs in healthcare.

During the meeting at NHA, Dr Indu Bhushan, CEO, NHA and Dr Dinesh Arora, Deputy CEO, NHA were keen to understand on the ground experience of hospitals that have been empanelled and serving AB-PMJAY beneficiaries. Regarding package rates, they said that “based on findings of the costing study being carried out by Department of Health Research (DHR), FICCI’s scientific costing study and other costing studies in healthcare, there will be further consultation with the industry for positive adjustments and rationalisation of package rates.”

Dr Alok Roy, Co-Chair, FICCI Health Services Committee and Chairman, Medica Group of Hospitals, appreciated the focus on streamlining implementation of AB-PMJAY and emphasised the need for accuracy in beneficiary identification, empowering hospitals operating in smaller towns and ensuring access for the most vulnerable out of the bottom 40 per cent of the covered population.

Complimenting the government on according ‘industry status’ to private hospitals, Dr Narottam Puri, Adviser- FICCI Health Services Committee; Board Member and Former Chairman- NABH; Adviser-Medical Operations and Chairman- Fortis Medical Council, Fortis Healthcare, said “FICCI’s Health Services Committee has been advocating for more than a decade for long-term financing options and viability gap funding for healthcare sector. Support from the government for land acquisition, clearances and funding will significantly boost expansion of healthcare infrastructure in tier II and III cities.”

The meeting was also attended by Dr Shakti Gupta, Medical Superintendent, RP Ophthalmic Center, AIIMS and Shobha Mishra Ghosh, Assistant Secretary General, FICCI.

AB-PMJAY’s aim to provide 10.74 crore poor and vulnerable families (nearly 50 crore beneficiaries) with an annual insurance cover of INR 5 lakhs per family for secondary and tertiary care hospitalisation, is expected to bring a tectonic shift in India’s healthcare delivery system at systemic, financial and infrastructural level.