Webinar: Financial impact of AB-PMJAY on government health facilities

Ayushman Bharat, a flagship scheme of Government of India has been launched to achieve the vision of Universal Health Coverage (UHC). This initiative has been designed to meet Sustainable Development Goals (SDGs) and its underlining commitment, which is to "leave no one behind."

An economic analysis found that additional funding through PMJAY results in an annual financial gain of ₹ 1839.3 million per year at the level of district hospitals in India.

This excess revenue could be used to either increase the quantity of health services and to improve their quality. With gradual increase in the coverage and service uptake under the PMJAY, the financial gains for the public district hospitals will also increase.

District hospitals can be further incentivised to strengthen the public sector and realize the broader goal of reducing financial hardship for patients.

Given that the PMJAY prices are uniform, the gatekeeping provision of certain services which require secondary care at district hospitals, or even similar secondary level private hospitals, will not only result in greater efficiency as the utilisation of care.

An increase in utilisation at the district hospitals would result in an efficient outcome from the payer’s perspective, as the National Health Authority stands to gain monetarily in that case. Hence, the increase in district hospital utilisation, irrespective of gatekeeping or a differential payment system, has significant potential to monetarily benefit the public sector or the payer.