NEW DELHI: Hospitals in different states will be paid differently for various surgeries and procedures under the Rs 5 lakh National Health Protection Mission under a new policy adopted by the Union Ministry of Health and Family Welfare.
The NHPS is aimed to cover about 40 crore Indians and will mean that they can avail about 1,350 surgeries and treatment procedures free-of-cost.
The development comes following a review of the rates proposed earlier by Niti Aayog which has also led to revision of rates of various treatment procedures.
A body of private hospitals had protested in a letter written to the government saying that majority of the big hospitals wont’ participate in what is being touted as the world’s largest health insurance scheme as the rates fixed for most surgeries and procedures are too low.
The ministry has now revised the rates and increased it by 11-15 per cent than what was proposed in the tender floated about three weeks back.
“The revision has been done following a detailed analysis by Niti Aayog and discussions with the stakeholders,” a senior health ministry official told TNIE. “An angioplasty in Punjab and Chhatisgarh, for instance does not cost the same so it makes sense to do the pricing appropriation in states,” he added.
The empanelment of hospitals is likely to begin on July 1 through state governments.
The revised policy also says that performance linked- payment system has been designed to incentivize hospitals to continuously improve quality and patient safety based on successive milestones.
“Hospitals qualifying for National Accreditation Boards for Hospitals and Healthcare Providers (NABH) entry-level accreditation will receive an additional 10 per cent while those qualifying for full accreditation will receive an additional 15 per cent,” the new policy says.
It adds that to promote equity in access, hospitals providing services in backward districts will receive an additional 10 per cent. In addition, states have the flexibility to increase rates up to 10 per cent or reduce them as much as needed to suit local market conditions.
“Further states could retain their existing package rates even if they are higher than the prescribed 10 per cent flexibility slab,” say the new guidelines.
An official in the ministry who is involved in rolling out of the plan said that with the tweaked rules, rates being offered under the scheme are higher than what the hospitals are paid through ongoing health insurance schemes in many states.
Private hospitals expressed satisfaction that the government has moved forward from its earlier proposal.
“We are happy that the government has taken our points into consideration and made some changes,” a senior executive with a corporate hospital in Delhi said.