The doctors’ association has been critical of the package rates under the National Health Protection Mission
With an eye on the participation of the private sector, the National Health Agency has reached out to the Indian Medical Association and the two have agreed to work together towards the implementation of Ayushman Bharat. IMA has been a bitter critic of the package rates for the National Health Protection Mission.
In the meeting between CEO Ayushman Bharat Indu Bhushan and IMA president Dr. Ravi Wankhedekar, the two sides agreed that while the differences on the package rates continue, IMA would work together with the government for successful implementation of the mission in the interest of the poor and weaker sections of the society. Ayushman Bharat was announced in the Union Budget this year as a two pronged health programme comprising of a tertiery care component and a primary care component. The package rates that are a bone of contention are for the Rs 5 lakh annual health cover for 10.74 crore families.
Bhushan explained that the package rates have been developed by a DGHS led committee based on the experience of existing states schemes as well as the previous national scheme – Rashtriya Swasthya Bima Yojana (RSBY).
Dr. Dinesh Arora mentioned that a performance-linked payment system has been designed to incentivize providers. This would continuously improve quality and patient safety, based on successive milestones. Hospitals qualifying for NABH entry-level certification will receive an additional 10%, while those qualifying for full accreditation will receive an additional 15%.
To promote equity in access, hospitals providing services in aspirational districts will receivean additional 10%. Teaching hospitals running PG/ DNB courses will be incentivized with 10 % higher package rates. In addition, States have the flexibility to increase rates up to 10 % or reduce them as much as needed to suit local market conditions. Further States could retain their existing package rates, even if they arehigher than the prescribed 10 % flexibility slab.
NHA clarified that NABH is not mandatory for the hospitals to get empaneled. However, NHA will encourage hospitals to get NABH (National Accreditation Board ofHealth) pre-entry level accreditation/ NQAS (National Quality Assurance Standards) for achieving quality milestones. The hospital with NABH/ NQAS accreditation can be incentivized for higher package rates subject to Procedure and Costing Guidelines.
