Ayushman Bharat

Ayushman Bharat

Ayushman Bharat, also known as the Pradhan Mantri Jan Arogya Yojana (PM-JAY), is a flagship health insurance scheme of the Government of India, aimed at providing health coverage to economically vulnerable families. Launched in 2018, it is part of the National Health Policy and seeks to achieve the vision of Universal Health Coverage (UHC).

Overview

Ayushman Bharat is designed to provide a health cover of ₹5 lakh per family per year for secondary and tertiary care hospitalization. The scheme targets over 10 crore poor and vulnerable families, approximately 50 crore beneficiaries, making it the world's largest government-funded healthcare program.

Objectives

The primary objectives of Ayushman Bharat are:

• To reduce the financial burden on poor and vulnerable groups arising out of catastrophic hospital episodes.
• To provide access to quality health services.
• To ensure that nobody is left behind in accessing healthcare services.

Components

Ayushman Bharat has two main components:

1. Health and Wellness Centres (HWCs)

The scheme aims to establish 1,50,000 Health and Wellness Centres across the country. These centers provide comprehensive primary healthcare services, including maternal and child health services, treatment for non-communicable diseases, and free essential drugs and diagnostic services.

2. Pradhan Mantri Jan Arogya Yojana (PM-JAY)

PM-JAY provides health insurance coverage for secondary and tertiary care hospitalization. It covers pre-existing conditions from day one and offers cashless and paperless access to services for the beneficiary at the point of service.

Eligibility

Eligibility for Ayushman Bharat is determined based on the Socio-Economic Caste Census (SECC) data. The scheme is targeted at the poor and vulnerable population, with specific criteria for rural and urban areas.

Implementation

The scheme is implemented by the National Health Authority (NHA) at the central level and by State Health Agencies (SHAs) at the state level. It is a centrally sponsored scheme with the cost shared between the central and state governments.

Impact

Since its inception, Ayushman Bharat has significantly increased access to healthcare services for the poor and vulnerable sections of society. It has led to increased hospital admissions and reduced out-of-pocket expenditure for beneficiaries.

Challenges

Despite its success, Ayushman Bharat faces several challenges, including:

• Ensuring quality of care across empaneled hospitals.
• Addressing fraud and abuse in the system.
• Expanding the network of empaneled hospitals, especially in rural areas.

Also see

• National Health Policy (India)
• Universal Health Coverage
• Public health in India
• Health insurance in India

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