Introduction
In 2018, the Government of India launched the ‘Ayushman Bharat’ scheme (as outlined by the National Health Policy 2017) to make healthcare services more accessible and affordable to citizens and aid the country in achieving its target of universal health coverage (UHC) by 2030.
The following are the two key components of ‘Ayushman Bharat’:
- Establish Health and Wellness Centres (HWCs): Launched in February 2018, the scheme aimed to provide extensive healthcare services to citizens closer to their homes by establishing 1,50,000 Health and Wellness Centres (HWCs).
- Pradhan Mantri Jan Arogya Yojana (PM-JAY): Launched in September 2018, the scheme aimed to offer secondary and tertiary care services to the vulnerable population in the society. The policy aimed to offer medical coverage of Rs. 5 lakh (US$ 6.63 thousand) per family per year for secondary and tertiary care hospitalisation to over 10.74 crore poor and vulnerable families (i.e., ~50 crore beneficiaries), which constitute the bottom 40% of India’s population.
The government’s increased focus to invest in the country’s healthcare infrastructure and establish India as a global healthcare hub will further expand accessibility of healthcare services to the Indian population and strengthen the overall healthcare system. The Indian healthcare sector reached US$ 180 billion in 2023 and it expected to reach US$ 320 billion by 2028. The government expenditure on healthcare increased by 6.27% YoY to Rs. 5,48,855 crore (US$ 30.70 billion) in BE 2022-23, as against Rs. 5,16,427 crore (US$ 63.76 billion) in RE 2021-22. As of January 2023, public health spending to country's GDP is 2.1% increase from 1.4% in 2020. In the fiscal year 2024-25, the Ministry has been granted a budget of Rs. 90,659 crore (US$ 10.9 billion), reflecting a 13% increase compared to the revised estimates of the previous fiscal year.
In September 2024, the Union Cabinet, has sanctioned health coverage for all individuals aged 70 and above, regardless of income, through the flagship initiative Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY). This initiative targets to assist around 4.5 Crore families, encompassing six crore senior citizens, with a US$ 5,985 (Rs. 5,00,000) health insurance coverage per family.
Need for Ayushman Bharat
The National Health Policy 2017 indicated the need to increase public healthcare spending in India due to rising demand for healthcare infrastructure & services and out-of-pocket expenditure.
Further, as per Health financing profile 2017 by World Health Organisation, the healthcare out-of-pocket expenditure (OOPE) in India was estimated at ~67.78% of the total health expenditure, higher than the world average of 18.2%, indicating high expenditure which leads to the high incidence of catastrophic expenditures and inequality.
To improve the public’s access to health services and meet the rising demand for healthcare infrastructure & services, the government introduced the ‘Ayushman Bharat’ scheme in September 2018. Following its launch, ~17 crore (68%) families have been estimated to be covered under PMJAY and other government-funded health schemes (e.g., Rashtriya Swasthya Bima Yojana, (RSBY), RSBY Plus, stated-owned schemes).
Ayushman Bharat: Key Initiatives and Progress
With the launch of Ayushman Bharat, India has reached a significant milestone in the pursuit for universal healthcare, as the scheme is ensuring extended services to all citizens through its twin pillars of Health & Wellness Centres (HWCs) and Pradhan Mantri Jan Arogya Yojana (PM-JAY) with bidirectional relations.
Health and Wellness Centres (HWCs)
As of 14th April 2024, more than 1,72,528 Ayushman Bharat Health and Wellness Centres (AB-HWCs) were operational across the country.
Pradhan Mantri Jan Arogya Yojana (PM-JAY)
Under the Ayushman Bharat’s Pradhan Mantri Jan Arogya Yojana (PM-JAY), 6.5 crore hospital were registered, as of January 2024.
|
Progress of PM-JAY |
|
|
Ayushman cards created |
34.17 crore (As of August 2024) |
|
Authorised Hospital Admissions (Count) |
7.4 crore (As of August 2024) |
According to Ayushman Bharat’s Pradhan Mantri Jan Arogya Yojana (PM-JAY) newsletter, 30,076 hospitals were empanelled, as of 14th April 2024.
Source: PMJAY
Status of implementation of Ayushman Bharat
|
Indicators |
All India |
|
Pradhan Mantri Jan Arogya Yojana (PM-JAY) |
|
|
Ayushman cards created |
30 crore |
|
Total hospital admissions authorised |
6.5 crore (as of April 2024) |
|
Health and Wellness Centres |
75,532 (as of April 2021) |
Private sector partnership
- In March 2021, the National Health Authority (NHA)—the apex government body responsible for implementing Ayushman Bharat Pradhan Mantri Jan Arogya Yojana—collaborated with UTI Infrastructure Technology and Services Limited (UTIITSL) to provide free PVC Ayushman Bharat card to PM-JAY beneficiaries in 11 states and union territories.
- In February 2021, ~10,000 private hospitals were empanelled under Ayushman Bharat PM-JAY, >600 hospitals under the Central Government Health Scheme (CGHS) and other private hospitals, under the State Government Health Insurance Scheme, participated as COVID-19 vaccination centres in India to ramp up COVID-19 vaccination capacity.
- In December 2020, the Asian Development Bank (ADB) approved a US$ 300 million loan to help India's urban areas strengthen and expand access to comprehensive primary healthcare and contribute to the Ayushman Bharat scheme.
- In April 2020, the NHA announced to provide complimentary COVID-19 testing and care at private laboratories and empanelled hospitals under Ayushman Bharat schemes for beneficiaries.
- To strengthen supply of care & treatment under the PM-JAY scheme, the NHA, in April 2020, initiated express empanelment for private hospitals to provide care for severe illnesses such as cancer and heart conditions.
- In 2020, the NHA joined forces with SAS (a software company) to facilitate the National Anti-Fraud Unit (NAFU) to help monitor fraud and abuse occurring anywhere in the scheme's implementation structure by using data analytics.
- In 2019, Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) collaborated with players such as Ola and Uber to enable comprehensive health insurance for their driver employees and their families to help them share benefits of this scheme and ensure their health and financial security.
- In 2019, the government partnered with Google to help speed up the digital exposure of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) by improving National Health Authority’s (NHA) digital presence and showcasing relevant content to 50 crore eligible beneficiaries.
- In 2019, Cipla collaborated with Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) to provide low-cost drugs to hospitals.
Other partnerships
The National Health Authority (NHA) collaborated with several other government, private and not-for-profit organisations to build expertise and skills to effectively implement the PM-JAY scheme.
|
Year |
Key partnerships |
Key capabilities |
|
2019 |
The German Government through GiZ |
The National Health Authority (NHA) partnered with the German Government through GiZ to develop capabilities in health benefit packages, support quality & policies, support state government; monitor and evaluate capacity building. |
|
2019 |
The World Bank |
The NHA partnered with the World Bank for capabilities in medical audits & claims adjudication, quality, capacity building, provider payment reforms & policy support, fraud management, monitor & evaluate health benefit packages, knowledge management and beneficiary empowerment. |
|
2019 |
Asian Development Bank |
The NHA partnered with Asian Development Bank for capabilities in capacity building, operations, policy support and research & information technology. |
|
2018 |
The National Skill Development Corporation |
The NHA partnered with National Skill Development Corporation for skill development. |
|
2019 |
The Indian Council of Medical Research |
The NHA partnered with Indian Council of Medical Research for capabilities in quality, health benefit packages and research. |
|
2019 |
GeM (Government e-Marketplace) |
The NHA partnered with GeM for capabilities in health benefit packages and innovations in healthcare. |
Source: Annual Report PM-JAY 2020
Union Budget 2024-25 Highlights
- In the Union Budget 2024-25, the government allocated funds worth Rs. 7,500 crore (US$ 901 million) in FY24 from Rs. 7,200 crore (US$ 887 million) in FY23, a 4.2% increase to the Ayushman Bharat-PM Jan Arogya Yojana (PM-JAY).
The Road Ahead
As part of sustainable development goals, India is focused on achieving universal health coverage for all citizens. The government allocated Rs. 90,171 crore (US$ 10.84 billion) for health in the Union Budget 2024-25. Leveraging technology for better implementation and monitoring of the scheme could be a key focus area for its future development.
With the help of Ayushman Bharat, the government is planning to further expand its benefits to millions by offering free medicines and diagnostics at HWCs and cover most secondary and tertiary procedures under the PM-JAY. The government’s initiative such as inclusion of AYUSH Health and Wellness Centre (AYUSH HWC) as component of Ayushman Bharat in National AYUSH Mission (NAM), would enable establishment of 12,500 Health and Wellness Centres (HWCs) by the Ministry of AYUSH, under the Ayushman Bharat Scheme, in a phased manner between FY20 and FY24.
Further, amid the COVID-19-induced lockdown in 2020, the scheme was widely used by migrant workers, particularly after the implementation of portability, which allowed beneficiaries to use cashless treatment facilities in any state, with the goal of providing access to healthcare.
With the government’s continuous efforts to increase AB’s awareness and strengthen the infrastructure, the Ayushman Bharat scheme is expected to gain higher momentum in the future and yojana meet its goal of achieving universal health coverage.
Partners
