Nearly six crore hospital admissions have been undertaken at a cost of worth Rs 77,298 crore under the Centre’s flagship health insurance scheme Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana (AB-PMJAY), the Lok Sabha was told
PM-JAY, India’s national health insurance program, is the largest publicly funded health insurance program in the world. It has reformed the way in which the poor and vulnerable access hospital care in India. The size of this program and the inclusion of private providers in delivering care has led to the implementation of a provider case-based payments scheme. Case-based payments are widely used throughout the world as a means of paying both individual and institutional health care providers in a manner that incentivizes efficiency relative to fee-for-service payment or traditional indemnity insurance payment.
The rate for ICU with ventilator support has been revised by 100 per cent and without ventilator by 136 per cent. Ayushman Bharat PM-JAY covers 1,669 treatment procedures out of which 1,080 are surgical and 588 medical.