Unsustainable Future of Ayushman Bharat

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In the picturesque region of Jammu and Kashmir, the Ayushman Bharat scheme, launched in 2018, had brought hope to millions of vulnerable individuals, providing them with access to quality healthcare services. However, the scheme is now facing a critical juncture due to delayed payments to healthcare providers. This has resulted in significant financial strain on private hospitals, leading to reduced staffing, compromised services, and decreased quality of care.Private hospitals in Jammu and Kashmir, like many others across the country, are struggling to sustain themselves under the Ayushman Bharat scheme. The delayed reimbursements have led to:

• Employment Drop: Reduced staffing or layoffs due to financial constraints, compromising hospitals’ ability to provide quality care.
• Performance Drop: Compromised services resulting from funding limitations, affecting patient experience.
• Quality Drop: Decreased quality of care due to resource constraints, jeopardizing patient safety and well-being.

Many private partners are stopping services under Ayushman Bharat, citing delayed payments as the primary reason. According to a recent report, 609 hospitals have opted out of the scheme across different states due to this issue. In Jammu and Kashmir, private hospitals are facing similar challenges. The 17th governance meeting of the State Health Agency decided to bar private hospitals from performing four major surgeries under the scheme, citing concerns about malpractice. These surgeries can now only be performed in government hospitals, further limiting access to quality healthcare services for vulnerable populations .

The Ayushman Bharat scheme was designed to benefit the bottom 40% of India’s population, approximately 55 crore individuals. However, the delayed payments have put the scheme’s very purpose at risk. If the scheme collapses, millions of vulnerable individuals in Jammu and Kashmir and across the country will be left without access to essential healthcare services, exacerbating health disparities and increasing out-of-pocket expenditure.

The Way Forward

To address the challenges facing Ayushman Bharat, the government must take immediate action to:

• Release Pending Payments: Clear the backlog of payments to private hospitals, ensuring they can continue to provide quality care without financial strain.
• Streamline Payment Processes: Implement efficient payment mechanisms to prevent future delays and ensure timely reimbursements.
• Strengthen Public-Private Partnerships: Foster collaboration between public and private healthcare providers to ensure the scheme’s success and sustainability.

The future of Ayushman Bharat hangs in the balance. Without immediate government intervention, the scheme may collapse, leaving millions of vulnerable individuals without access to essential healthcare services. The government must take prompt action to address the challenges facing the scheme, ensuring its sustainability and continued impact. By doing so, Ayushman Bharat can fulfill its promise of providing universal health coverage to India’s most vulnerable populations.