K’taka Govt to Overhaul AB-ArK Health Scheme for Enhanced Coverage & Access

A key development in the AB-ArK health scheme is the state health department's plan to remove the referral system for high-end tertiary care procedures.

The Karnataka government is intensifying its efforts to enhance the AB-ArK health scheme, an initiative designed to provide comprehensive healthcare coverage to the state’s residents.

The scheme, which offers cashless treatments and medical services, is undergoing significant updates to improve accessibility and efficiency.

One of the most notable developments in the AB-ArK health scheme is the state health and family welfare department’s consideration of removing the referral system for high-end tertiary care procedures.

Currently, patients requiring complex treatments must first be referred by a government hospital to a private facility. This process, however, has been identified as a significant source of inconvenience for many patients, particularly those in urgent need of specialized care.

Health sector experts have pointed out that the existing referral system often leads to increased travel, extended waiting times, and coordination challenges, all of which can delay access to necessary medical attention.

The additional bureaucracy involved in the referral process can be frustrating for patients, potentially leading to longer wait times for critical procedures.

The proposed removal of this system aims to streamline the process, allowing patients to directly access the care they need without unnecessary delays.

Comprehensive Coverage of Procedures

The AB-ArK scheme currently covers a wide range of medical procedures—1,650 in total—ensuring that patients have access to both routine and complex medical treatments.

According to the state health department, these procedures are categorized into secondary, complex secondary, tertiary, and emergency care.

The scheme includes 545 secondary care procedures, which involve less complex interventions that do not require advanced technology or specialized skills.

These procedures are typically more routine and are accessible at various healthcare facilities across the state.

For more advanced needs, the scheme covers 251 complex secondary procedures, which involve specialized techniques and equipment, though they do not reach the complexity of tertiary care.

Medical experts from Victoria Hospital have highlighted that these procedures, while more intricate, are still manageable within many healthcare settings without the need for highly specialized centers.

The most complex category, comprising 934 tertiary care procedures, involves highly specialized medical care typically provided in teaching hospitals or specialized centers.

Junior doctors from Lady Curzon & Bowring Hospital explained that tertiary care procedures include organ transplants, advanced cancer treatments, and complex neurosurgeries—treatments that require significant expertise and advanced medical technology.

Additionally, the AB-ArK scheme covers 171 emergency procedures, which address critical and life-threatening situations such as trauma care and other immediate life-saving interventions.

These procedures are vital for stabilizing patients and providing urgent medical attention when time is of the essence.

Future Improvements & Direct Access to Care

In response to feedback from healthcare professionals and patients, the Karnataka government, led by Health Minister Dinesh Gundu Rao, is exploring the possibility of allowing patients direct access to specialized care, bypassing the current referral system.

This change could significantly reduce wait times and administrative burdens, particularly for surgeries and treatments that cannot be performed in government hospitals.

The proposed reforms would be particularly beneficial for patients from rural areas, who often need to travel to major cities including Bengaluru or Mysuru for tertiary care.