Covid-19 crisis: Private hospitals get a lifeline from Ayushman Bharat

Despite the pandemic raging across the country, patient footfall for Ayushman Bharat fell during the lockdown period.
Small private hospitals, struggling to survive because of a sharp drop in patient footfall -- and hence revenue -- are seeing a lifeline in the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY).

The Centre's flagship scheme, which gives annual healthcare benefits of up to Rs 5 lakh for every entitled family, has on-boarded about 1,000 new hospitals, mostly private, in the last one month, even as the number of cases it handled fell by 60 per cent. It is also expected that 200-1,000 diagnostic tests a day (for Covid-19) would be conducted in coming months under the scheme. At the moment, call centres operated by the PMJAY are reaching out to high-risk individuals and advising them about precautions to take.

Speaking to Business Standard, Indu Bhushan, chief executive officer of the National Health Authority (NHA) and the PMJAY, said, “In the last one month, close to 1,000 new hospitals have come on board and we have also launched something called empanelment light. Some of the requirements have been diluted, and we have allowed certain provisions. For example, a hospital can now be empanelled for only three months.”

The process of approval, too, has been made easier. The reason for so many new hospitals coming on board is that they see this as a source of revenue, said Bhushan, adding it is a win-win situation. “This way we are also able to provide services, and hospitals can generate some revenue,” he said.

As such, overall patient numbers have come down by about 60 per cent for the PMJAY, but chronic ailment treatments like dialysis have come down by only 15 per cent.

“We are hoping now with the easing of restrictions, these numbers will grow as there will be a pent-up demand. A lot of elective surgeries and health procedures have been put on hold. We used do about 25,000-30,000 treatments or admissions every day, which is down to 12,000 cases or so per day,” Bhushan said, adding that he expected the numbers to touch around 25,000 a day by the end of this month.

Despite the pandemic raging across the country, patient footfall for Ayushman Bharat fell during the lockdown period. The scheme is covering Covid-19 positive patients too. However, it did not see much demand for that. Bhushan explained that so far India's total coronavirus positive cases were just above 40,000 and of these around 80 per cent were asymptomatic.

“Only a fraction of these need intensive care,” he said.

The role of the private sector has thus been marginal so far in the pandemic. With the lockdown easing, and patient numbers growing, the share of private healthcare in treating Covid-19 is expected to rise.

So far, the private healthcare sector has faced the brunt, with an 80 per cent drop in out-patient department (OPD) visits and the industry in-patient occupancy levels reaching 30 per cent. Most large chains have already cut salaries of their staff and are waiting for the lockdown curbs to ease so that patient footfall is back.

"Fear of catching infection, and transport issues have kept patients away. We are witnessing some growth in patient arrivals since last week," said Sanjeev Goel, managing director of Saraswati Heart Care and Research Centre in Allahabad. This hospital is in the process of getting empanelled under the PMJAY.

At present, over 21,000 hospitals are empanelled with the PMJAY. Some of the big corporate hospitals too are part of PMJAY. These include Apollo Hospitals, HCG, Sir Ganga Ram, Medanta the Medicity, among other smaller ones. Private facilities account for over 50 per cent of the PMJAY's overall treatment.

Big corporate hospitals, however, are not banking on the scheme for revenue just yet. The CEO of a corporate hospital chain that has significant presence in the southern market said, "Smaller and standalone private hospitals, especially the ones in smaller towns and cities, will benefit by enrolling themselves as they will get a steady patient flow in tertiary care like cardiac stent surgeries.

Some of these hospitals, which are mostly family-run enterprises, are struggling with their finances at the moment. But the PMJAY is not a source of revenue for larger corporate hospitals; it is more of a social responsibility."

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