It stated that the state government has decided to review the Health Benefits Package and other terms in the Insurance Contract of MHIS 6 and will cover over 7 lakh families in Meghalaya, providing them with comprehensive health insurance coverage that will meet their secondary and tertiary care hospitalisation, outpatient care, diagnostic tests, and follow-up care.
Ayushman Sabha will be a village-level campaign led by the village health, sanitation and nutrition committee to ensure the benefits of all the health schemes of the central and state governments reach the intended beneficiaries.
In the state budget presented in February, state Finance Minister Kanubhai Desai had announced the doubling of insurance cover under PMJAY-MA scheme from Rs 10 lakh from Rs 5 lakh. Now, the announcement has been operationalised.
Narendra Singh, Programme Manager (Adoption), Ayushman Bharat Digital Health Mission, National Health Authority (NHA) in the valedictory address on ‘Advantages of ABDM for Pathologists & LMIS providers’ at ETHealthworld’s India Diagnostic Summit, on June 16, clarified that Ayushman Bharat Digital Health Mission (ABDM) is different from the Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) scheme. He brought up this issue because there has been a misconception that both these schemes are related.
In terms of gender, though enrolment under the scheme is almost equal for men and women, the total number and value of claims were higher for males. And though private hospitals constituted 56 per cent of empanelled hospitals, they accounted for 75 per cent of the money spent on reimbursing claims under PMJAY.
In a written response to another question, Minister of State for Health Bharati Pravin Pawar said that till February 2, the overall percentage of the total claims paid against total claims submitted under the scheme is approximately 77 per cent, while the percentage of claims paid to private hospitals is 86 per cent.
The amount allocated for PMJAY in the 2021-22 budget was Rs6,400 crore, but in actuality, only Rs3,115 crore were spent, said health activist Dr Anant Phadke.
Under the new model, the providers will be rewarded for helping the patients improve their health, which consequently will reduce the effects of disease in the population in the long term. The objective is to incentivise and encourage healthcare providers to focus on delivering patient-centric services. The new model aims to shift the focus of measuring hospital performance away from the volume of services provided and toward the value of healthcare services.
The entire idea of resilience is based on how soon and how well health systems recover after experiencing a health shock. And after they have recovered, how do they improve so that they can absorb the complexities of the future.
Pradhan Mantri Jan Arogya Yojna, which provides Rs 5 lakhs insurance coverage to poor patients, hasn't been approved by the state government yet. I appeal to the state government of Odisha to approve it, said Bharati Pravin Pawar.
Terming this as a momentous day, Union Health Minister Dr. Mansukh Mandaviya hailed this MoU as one of its kind in the country which will give impetus to ensuring rightful and respectable place for transgender community by accessing healthcare services under AB-PMJAY.
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