Written by : Jayati Dubey
October 9, 2023
AB-PMJAY is structured to provide financial safeguards against overwhelming healthcare costs and is executed using insurance, trust, or mixed approaches based on the preferences and decisions of individual states.
The Ayushman Bharat Pradhan Mantri Jan Arogya Yojna (AB-PMJAY), has saved at least INR 1 Lakh Cr in treatment expenses over the five years since its inception in 2018, according to data from the Union Ministry of Health and Family Welfare.
As per the data, the scheme has provided cashless treatments valued at over INR 5.7 Cr and generated 25.4 Cr beneficiary cards. Under the AB-PMJAY, the world's largest public health protection initiative, eligible beneficiary families receive health coverage of INR 5 Lakh annually. Beneficiaries are identified based on specific deprivation and occupational criteria.
AB-PMJAY is designed to offer financial risk protection against catastrophic healthcare expenses and is implemented through insurance, trust, or mixed models as determined by individual states.
Government data reveals that 27,343 hospitals are empanelled under the scheme, providing both cashless and portable treatment options.
Speaking about the accomplishments of the scheme, Union Health Secretary Sudhansh Pant said, "Around 60% of the amount has been used for tertiary care hospitalisation, which was one of the primary objectives of PM-JAY when it was launched."
Furthermore, Pant noted that, on average, 177 Ayushman PMJAY cards are issued every minute, with 30 hospital admissions occurring per minute. Remarkably, 48% of hospitalisations involve female beneficiaries, and an average of eight hospitals are being empanelled each day.
While the scheme has been implemented in 33 states and Union territories, three states'”Odisha, West Bengal, and Delhi'”are yet to adopt it.
AB-PMJAY aims to extend healthcare coverage to more than 12 Cr economically disadvantaged families, comprising approximately 55 Cr beneficiaries, constituting the bottom 40% of India's population. The selection of households is based on specific deprivation and occupational criteria as per the Socio-Economic Caste Census 2011 (SECC 2011) for rural and urban areas.
Previously known as the National Health Protection Scheme (NHPS), PM-JAY underwent a name change and absorbed the Rashtriya Swasthya Bima Yojana (RSBY), initiated in 2008. Consequently, the PM-JAY coverage includes families previously enrolled in RSBY but not featured in the SECC 2011 database.
Importantly, PM-JAY is entirely funded by the Government, and the cost of implementation is shared between the Central and State Governments.
In a separate development, after two years of the Ayushman Bharat Digital Mission's launch, more than 450 million Ayushman Bharat health IDs have been generated. The mission has also witnessed the registration of over 2.19 Lakh health facilities and the inclusion of over 2.28 Lakh health professionals.
The Ayushman Bharat Pradhan Mantri Jan Arogya Yojna continues to make strides in improving healthcare accessibility and affordability for millions of Indians, demonstrating its impact on reducing the financial burden of healthcare expenses and promoting the overall well-being of the population.