{"id":52446,"date":"2019-09-23T19:00:22","date_gmt":"2019-09-23T13:30:22","guid":{"rendered":"https:\/\/blogadmin.forumias.com\/?p=52446"},"modified":"2019-09-23T16:58:46","modified_gmt":"2019-09-23T11:28:46","slug":"7-pm-in-one-year-pm-jay-has-created-a-framework-for-comprehensive-universal-healthcare-23rd-september-2019","status":"publish","type":"post","link":"https:\/\/forumias.com\/blog\/7-pm-in-one-year-pm-jay-has-created-a-framework-for-comprehensive-universal-healthcare-23rd-september-2019\/","title":{"rendered":"7 PM | In one year, PM-JAY has created a framework for comprehensive universal healthcare | 23rd September, 2019"},"content":{"rendered":"\n<p><strong>Context: <\/strong>Insights on\nAyushman Bharat Scheme.<\/p>\n\n\n\n<p><strong>More in news:<\/strong> A year ago, on\nSeptember 23, the prime minister launched the \u2018(Pradhan Mantri Jan Arogya\nYojana<strong>&nbsp;<\/strong>PM-JAY)\u2019 in Ranchi, Jharkhand.<\/p>\n\n\n\n<p><strong>Ayushman\nBharat:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Ayushman\nBharat, a flagship scheme of Goverment of India was launched as recommended by\nthe National Health Policy 2017, to achieve the vision of Universal Health\nCoverage (UHC). <\/li><li>This\ninitiative has been designed on the lines as to meet SDG and its underlining\ncommitment, which is &#8220;leave no one behind&#8221;.<\/li><li>Ayushman\nBharat is an attempt to move from sectoral and segmented approach of health\nservice delivery to a comprehensive need-based health care service. <\/li><li><strong>Aim of Ayushman\nBharat:<\/strong>\nThe aim is to undertake path breaking interventions to holistically address\nhealth (covering prevention, promotion and ambulatory care), at primary,\nsecondary and tertiary level. <\/li><li>The\nscheme adopts a continuum of care approach, comprising of two inter-related\ncomponents:<ul><li>Health\nand Wellness Centres (HWCs)<\/li><\/ul><ul><li>Pradhan\nMantri Jan Arogya Yojana (PM-JAY)<\/li><\/ul><\/li><\/ul>\n\n\n\n<p><strong>Health and Wellness Centres (HWCs):<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>The Government of India in 2018 announced the creation of\n1,50,000 Health and Wellness Centres (HWCs) by transforming existing Sub\nCentres and Primary Health Centres.&nbsp;<\/li><li><strong>Functions:\n<\/strong><\/li><li>These\ncentres would deliver Comprehensive Primary Health Care (CPHC) bringing\nhealthcare closer to the homes of people covering both maternal and child\nhealth services and non-communicable diseases, including free essential drugs\nand diagnostic services.<\/li><li>Health\nand Wellness Centers, are envisaged to deliver an expanded range of services to\naddress the primary health care needs of the entire population in their area,\nexpanding access, universality and equity close to the community. <\/li><li>The\nemphasis of health promotion and prevention is designed to bring focus on\nkeeping people healthy by engaging and empowering individuals and communities\nto choose healthy behaviours and make changes that reduce the risk of\ndeveloping chronic diseases and morbidities.<\/li><\/ul>\n\n\n\n<p><strong>Pradhan\nMantri Jan Arogya Yojana (PM-JAY):<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>The\nsecond component under Ayushman Bharat is PM-JAY, which aims at providing\nhealth insurance cover of Rs. 5 lakhs per family per year for secondary and\ntertiary care hospitalization to over 10.74 crores poor and vulnerable families\n(approximately 50 crore beneficiaries). <\/li><li>There\nis no cap on the family size under the scheme. <\/li><li>This\nscheme was earlier known as National Health Protection Scheme (NHPS) before it\nwas rechristened to PM-JAY. <\/li><li>PM-JAY\nhas been rolled out for the bottom 40% of poor and vulnerable population. <\/li><li>The\nhouseholds included are based on the deprivation and occupational criteria of\nSocio-Economic Caste Census 2011 (SECC 2011) for rural and urban areas\nrespectively. <\/li><li>The\nscheme subsumed then existing Rashtriya Swasthya Bima Yojana (RSBY), launched\nin 2008. <\/li><li>PM-JAY\nis completely funded by the Government, and cost of implementation is shared\nbetween Central and State Governments.<\/li><\/ul>\n\n\n\n<p><strong>Role of Private\nHospitals:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>More than half of the empaneled hospitals are\nprivate. <\/li><li>Over 62 per cent of the treatments have been done\nby private hospitals. <\/li><li>PM-JAY has created a massive demand for private\n(and public) sector services by making hospital facilities accessible to 55\ncrore people. <\/li><li>In tier II and tier III cities, private sector\nhospitals are already witnessing an almost 20 per cent increase in footfall.<strong><\/strong><\/li><\/ul>\n\n\n\n<p><strong>Pradhan Mantri Arogya Mitras:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>The\nPradhan Mantri Arogya Mitra is the primary contact for the beneficiaries at\nevery empanelled hospital care provider.<\/li><li>Pradhan\nMantri Arogya Mitra plays three main roles under AB PM-JAY.<\/li><li>As\na Trusted Partner of Beneficiaries<\/li><li>As\na Representative of Authorities <\/li><li>As\na System Operator. <\/li><li>The\nPradhan Mantri Arogya Mitra shall be responsible for the following broad areas:<\/li><li>Guiding\nthe Beneficiary about the overall benefits under AB PM-JAY and providing\ninformation about receiving prompt treatment at Empanelled Health Care Provider.<\/li><li>Operating\nthe Beneficiary Identification System to identify and verify the beneficiaries\nentitled under AB PM-JAY <\/li><li>Operating\nthe Transaction Management System such as submitting requests for\nPreAuthorization, Updating Surgery\/Treatment Details and Filing for Claims <\/li><li>Ensure\nthe privacy and confidentiality of personal and sensitive beneficiary\ninformation is maintained while operating IT systems under AB PM-JAY.<\/li><\/ul>\n\n\n\n<p><strong>Use of ICT:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>It is supported by a strong IT backbone that\nfacilitates the identification of beneficiaries, records treatments, processes\nclaims, receives feedback, and addresses grievances. <\/li><li>A live dashboard helps in monitoring and\nimproving performance, based on real-time data and regular analysis. This\nplatform also helps states to compare their performance. <\/li><li>Strong and sophisticated fraud prevention,\ndetection and control system at the national and state level has proved to be\ncritical for PM-JAY to ensure that frauds are largely prevented.<\/li><\/ul>\n\n\n\n<p><strong>Opportunities ahead:<\/strong> <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Exploiting the potential of collective bargaining\nand leveraging economies of scale. This could deliver more affordable and\nquality healthcare by negotiating better prices for various devices, implants\nand supplies, and also leveraging other policies such as Make in India. <\/li><li>Ensuring quality treatment of patients by\nprescribing and ensuring adherence to standard treatment protocols is another\nopportunity waiting to be fully harnessed. <\/li><li>Further strengthening the linkage between HWCs\nand PMJAY will improve the backward and forward referrals and enhance overall\nhealthcare services, especially to the poor. <\/li><li>\u201cGreen field\u201d states with no past experience of\nimplementing healthcare schemes have to work harder to scale up their progress.\nAll states will need to make sincere efforts towards providing seamless health\nservices to the last mile.<strong><\/strong><\/li><\/ul>\n\n\n\n<p><strong>Source: <\/strong><a href=\"https:\/\/indianexpress.com\/article\/opinion\/columns\/pmjay-scheme-india-health-sector-ayushman-bharat-modi-govt-6018952\/\">https:\/\/indianexpress.com\/article\/opinion\/columns\/pmjay-scheme-india-health-sector-ayushman-bharat-modi-govt-6018952\/<\/a><strong><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Context: Insights on Ayushman Bharat Scheme. More in news: A year ago, on September 23, the prime minister launched the \u2018(Pradhan Mantri Jan Arogya Yojana&nbsp;PM-JAY)\u2019 in Ranchi, Jharkhand. Ayushman Bharat: Ayushman Bharat, a flagship scheme of Goverment of India was launched as recommended by the National Health Policy 2017, to achieve the vision of Universal&hellip; <a class=\"more-link\" href=\"https:\/\/forumias.com\/blog\/7-pm-in-one-year-pm-jay-has-created-a-framework-for-comprehensive-universal-healthcare-23rd-september-2019\/\">Continue reading <span class=\"screen-reader-text\">7 PM | In one year, PM-JAY has created a framework for comprehensive universal healthcare | 23rd September, 2019<\/span><\/a><\/p>\n","protected":false},"author":61,"featured_media":49370,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"footnotes":""},"categories":[130,9],"tags":[],"class_list":["post-52446","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-7-pm","category-public","entry"],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/forumias.com\/blog\/wp-content\/uploads\/2019\/07\/7-PM.png?fit=1000%2C500&ssl=1","views":{"total":0,"cached_at":"","cached_date":1704766265},"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/posts\/52446","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/users\/61"}],"replies":[{"embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/comments?post=52446"}],"version-history":[{"count":0,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/posts\/52446\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/media\/49370"}],"wp:attachment":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/media?parent=52446"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/categories?post=52446"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/tags?post=52446"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}