The National Health Authority of India will now encourage hospitals to provide valuable services through a new initiative.
Under the leading insurance scheme Ayushman Bharat Pradhan Mantri Jan Arogya Yojana or AB PM-JAY, the agency will now shift its focus from the quantity or volume of services provided to the value of the service to measure and performance ratings of healthcare providers.
According to the press release, hospitals affiliated with AB PM-JAY will be paid and rewarded based on five performance metrics:
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beneficiary satisfaction
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Re-hospitalization rate
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Out-of-pocket spending,
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claim confirmation
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Improve the patient’s health-related quality of life
NHA notes that a hospital’s performance not only determines financial dynamics, but also creates demand for quality treatment for patient beneficiaries.
Their performance scores will be made available on a public dashboard to help AB PM-JAY beneficiaries make informed decisions.
WHY IT IMPORTANT
NHA seeks to introduce the concept of value-based care in India’s public health ecosystem. It believes that the move to a new measure of incentives and performance evaluation, along with the use of health technology assessment and digital tools to monitor quality of care, will help transform the AB program. PM-JAY and the entire Indian healthcare system to one value-based platform. health care delivery system.
It added that the change would result in a “significant increase” in overall health and was expected to be “win-win” for all parties involved. The NHA explains: “Although patients will get better health outcomes and greater satisfaction from the services they receive, providers will get better results. as such, the payer will be able to maximize the health benefits generated from the expenditure incurred”.
The agency adds that in a value-based system, payers can also exercise robust cost controls, resulting in a reduction in their investments and premium pools. surname. Providers will also benefit from being able to align their products and services with positive patient outcomes and reduce costs.
TREND TO BIGGER
NHA has taken various measures to ensure that AB PM-JAY beneficiaries are receiving both cashless healthcare benefits and high quality care at partner hospitals. Recently, it has standardized treatment costs and added new and advanced treatment procedures that are covered by insurance.
In other related news, the agency announced last week that it will provide incentives up to Rs 40 million (nearly USD 500,000) for healthcare facilities and digital solution providers are driving the creation of Ayushman Bharat Medical Account. It is one of the latest efforts to accelerate digital health transactions across India under the Ayushman Bharat Digital Mission, a government program that is building the country’s digital health ecosystem. .
