Two private players been enrolled to conduct desk medical audits as part of the Jan Arogya Yojana, India’s prestigious public health insurance project. The scheme has so far covered about 17.4 crore beneficiaries against a target of 50 crore beneficiaries.
Two private players have entered India’s Ayushman Bharat Pradhan Mantri Jan Arogya scheme (PM-JAY). The agencies have been enrolled by the National Health Authority (NHA) to conduct desk medical audits.
The two private agencies, Inches healthcare and IQVIA Consulting and Information Services India Pvt Ltd., have been empanelled for an initial period of two years. The agencies are not allowed to sub-contract their work. (The wording of the document uses a mix of the terms empanelment/empanelled and contract.)
Inches Healthcare Private Limited is a private unlisted company incorporated in 1995. The other company, IQVIA Consulting and Information Services India claims to specialise in providing advanced analytics, technology solutions, and clinical research services to the life sciences industry.
More private players in the pipeline
Investigations by OWSA reveal that another six private players have been empanelled for conducting investigation and verification under the PM Jan Arogya Yojana for a period of two years.
NHA is the apex body responsible for implementing the ambitious flagship public health insurance assurance scheme.
21 (mostly private) insurance companies were shortlisted earlier in July this year for participation in Insurance Pilots covering ‘Missing middle/non-poor population’. The public sector insurance companies among these included National Insurance Co. Ltd., The New India Assurance Co. Ltd. and The Oriental Insurance Co. Ltd.
Low enrollment a concern
Officials in the Ministry of Health and Family Welfare are concerned that the NHA has issued less than 17.4 crore beneficiaries with Ayushman Cards to beneficiaries since the scheme was launched to include 50 crore beneficiaries as part of the National Health Policy in 2017. This number includes 5.85 crore beneficiaries enrolled by the state governments.
8.3 lakh COVID-19 patients hospitalised under Ayushman Bharat
Earlier in December, the government informed Parliament that over 8.3 lakh people infected with COVID-19 were admitted to hospitals across the country under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY).
Much is tucked away in the jargon of the Ayushman Bharat Pradhan Mantri Jan Arogya scheme. For example, an Ayushman Bharat health infrastructure mission has been designed to financially augment and strengthen the critical healthcare network for some 50 crore beneficiaries. These include the creation of elaborate diagnostics and treatment facilities, monitoring of diseases and the expansion of existing research institutions that study pandemics.