India's Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY), the largest government-funded health insurance scheme, has enrolled 27,742 hospitals, 43% of which (11,973) are private hospitals, with 1.3 million beds. However, private hospitals are struggling financially under the scheme, citing delays and inadequate reimbursement rates. Introduced in 2018, PM-JAY aims to provide Rs. 5 lakh (~$6,100) per family annually for secondary and tertiary care hospitalisation, covering pre-hospitalisation and 15 days of post-hospitalisation expenses including diagnostics and medicines. Reports indicate that many private hospitals are lately reluctant to admit patients despite having available beds, primarily due to delays in government reimbursement of insurance claims.
July 4, 2024