PIB Analysis 10-01-23
National Health Authority (NHA) introduces new system
- National Health Authority (NHA) introduces a new system to measure and grade hospital performance under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY).
- Its objective is to shift the focus of measuring performance of hospitals from volume of services provided to the value of healthcare services.
- The new initiative will introduce the concept of ‘value- based care’, where payment will be based on outcome and providers will be rewarded according to the quality of the treatment delivered.
- Under the new model, the providers will be rewarded for helping the patients improve their health, which will consequently reduce the effects of disease in the population in the long term.
- The step promises significant increase in the overall health gains and is expected to be a win-win for all concerned stakeholders from patients to healthcare providers, payers and suppliers.
- While the patients will get better health outcomes and higher satisfaction out of the services they receive, providers stand to get better care efficiencies.
Under value-based care, the performance of AB PM-JAY empanelled hospitals will be measured based on five performance indicators such as:
- Beneficiary Satisfaction;
- Hospital Readmission Rate;
- The extent of Out-of-Pocket Expenditure;
- Confirmed Grievances and
- Improvement in-patient’s Health-Related Quality of Life.
The performance of the hospitals based on the above indicators shall also be made available on a public dashboard that will help the beneficiaries to make an informed decision.
In this way, the hospital performance shall not only determine the financial incentive of the hospital but also create a demand for quality treatment of beneficiaries under PMJAY.