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Ayushman Bharat Yojana
National Health Protection Scheme
DR.T.V.RAO MD
1
๏ต Ayushman Bharat Yojana
will be launched on 25
September 2018.
Beneficiaries will receive
Ayushman Bharat Family
Health Cards The key
stakeholders in the scheme
besides the consumers or
beneficiaries are the
Healthcare Providers, state
governments and
Insurance companies
without whose support and
involvement the execution
of this scheme cannot
happen.
2
Dr.T.V.Rao MD @Ayushman Bharat 9/14/2018
PM MODIS VISION TO INDIA FOR
EMPOWERING THE LIVES OF INDIANS
9/14/2018Dr.T.V.Rao MD @Ayushman Bharat
3
BETTER HEALTH A UNIVERSAL DEMAND
Ayushman Bharat Yojana fulfills the demand
4
Dr.T.V.Rao MD @Ayushman Bharat
Health Minister, JP Nadda, stated
๏ต The Health Minister, JP Nadda,
stated that the government is set
to allocate 100 billion Rupees
($1.54 billion) for its ambitious
health Programme, the Ayushman
Bharatโ€“ National Health Protection
Mission. Being dubbed as the
largest public health scheme in
the world, it is expected to be
funded by both the central and
state governments every year.
9/14/2018Dr.T.V.Rao MD @Ayushman Bharat
5
Ayushman Bharat Programme
VISON TO HEALTHY INDIA
๏ต The Government today
announced two major initiatives
in health sector , as part of
Ayushman Bharat Programme.
The Union Minister for Finance
and Corporate Affairs, Shri Arun
Jaitely while presenting the
General Budget 2018-19 in
Parliament here today said that
this was aimed at making path
breaking interventions to
address health holistically, in
primary, secondary and tertiary
care systems, covering both
prevention and health
promotion.
9/14/2018Dr.T.V.Rao MD @Ayushman Bharat
6
FEATURES OF Ayushman Bharat
๏ต Ayushman Bharat - National Health Protection Mission will have a defined benefit
cover of Rs. 5 lakh per family per year.
๏ต Benefits of the scheme are portable across the country and a beneficiary covered
under the scheme will be allowed to take cashless benefits from any public/private
empanelled hospitals across the country.
๏ต Ayushman Bharat - National Health Protection Mission will be an entitlement based
scheme with entitlement decided on the basis of deprivation criteria in the SECC
database.
๏ต The beneficiaries can avail benefits in both public and empanelled private
facilities.
๏ต To control costs, the payments for treatment will be done on package rate (to be
defined by the Government in advance) basis.
9/14/2018Dr.T.V.Rao MD @Ayushman Bharat
7
FEATURES OF Ayushman Bharat
๏ต One of the core principles of Ayushman Bharat - National Health Protection
Mission is to co-operative federalism and flexibility to states.
๏ต For giving policy directions and fostering coordination between Centre and
States, it is proposed to set up Ayushman Bharat National Health Protection
Mission Council (AB-NHPMC) at apex level Chaired by Union Health and Family
Welfare Minister.
๏ต States would need to have State Health Agency (SHA) to implement the scheme.
๏ต To ensure that the funds reach SHA on time, the transfer of funds from Central
Government through Ayushman Bharat - National Health Protection Mission to
State Health Agencies may be done through an escrow account directly.
๏ต In partnership with NITI Aayog, a robust, modular, scalable and interoperable IT
platform will be made operational which will entail a paperless, cashless
transaction.
9/14/2018Dr.T.V.Rao MD @Ayushman Bharat
8
BRINGING IN BILLION CHEERS TO EVERY
INDIAN
9/14/2018Dr.T.V.Rao MD @Ayushman Bharat
9
BRINING AFFORDABLE
HEALTH CARE TO BILLION CITIZENS OF
INDIA
9/14/2018Dr.T.V.Rao MD @Ayushman Bharat
10
IMPLEMENTATION STRATEGY
๏ต At the national level to manage, an
Ayushman Bharat National Health
Protection Mission Agency (AB-
NHPMA) would be put in place. States/
UTs would be advised to implement
the scheme by a dedicated entity
called State Health Agency (SHA). They
can either use an existing Trust/
Society/ Not for Profit Company/ State
Nodal Agency (SNA) or set up a new
entity to implement the scheme.
9/14/2018Dr.T.V.Rao MD @Ayushman Bharat
11
HOW TO
IMPLEMENT
๏ต States/ UTs can
decide to implement
the scheme through
an insurance
company or directly
through the Trust/
Society or use an
integrated model.
9/14/2018Dr.T.V.Rao MD @Ayushman Bharat
12
9/14/2018Dr.T.V.Rao MD @Ayushman Bharat
13
Major Impact
๏ต Ayushman Bharat - National Health
Protection Mission will have major impact
on reduction of Out of Pocket (OOP)
expenditure on ground of:
๏ต Increased benefit cover to nearly 40% of
the population, (the poorest & the
vulnerable)
๏ต Covering almost all secondary and many
tertiary hospitalizations. (except a
negative list)
๏ต Coverage of 5 lakh for each family, (no
restriction of family size)
9/14/2018Dr.T.V.Rao MD @Ayushman Bharat
14
Major Impact
๏ต This will lead to increased
access to quality health and
medication. In addition, the
unmet needs of the
population which remained
hidden due to lack of
financial resources will be
catered to. This will lead to
timely treatments,
improvements in health
outcomes, patient
satisfaction, improvement in
productivity and efficiency,
job creation thus leading to
improvement in quality of life.
9/14/2018Dr.T.V.Rao MD @Ayushman Bharat
15
EXPENDITURE INVOLVED
๏ต The expenditure incurred in premium payment will be shared
between Central and State Governments in specified ratio as per
Ministry of Finance guidelines in vogue. The total expenditure will
depend on actual market determined premium paid in States/ UTs
where Ayushman Bharat - National Health Protection Mission will be
implemented through insurance companies. In States/ UTs where the
scheme will be implemented in Trust/ Society mode, the central share
of funds will be provided based on actual expenditure or premium
ceiling (whichever is lower) in the pre-determined ratio.
9/14/2018Dr.T.V.Rao MD @Ayushman Bharat
16
NUMBER OF BENEFICIARIES
๏ต Ayushman Bharat - National Health
Protection Mission will target about 10.74
crore poor, deprived rural families and
identified occupational category of
urban workers' families as per the latest
Socio-Economic Caste Census (SECC)
data covering both rural and urban. The
scheme is designed to be dynamic and
aspirational and it would take into
account any future changes in the
exclusion/ inclusion/ deprivation/
occupational criteria in the SECC data
9/14/2018Dr.T.V.Rao MD @Ayushman Bharat
17
STATES/DISTRICTS COVERED
๏ต Ayushman Bharat -
National Health
Protection Mission will
be rolled out across
all States/UTs in all
districts with an
objective to cover all
the targeted
beneficiaries.
9/14/2018Dr.T.V.Rao MD @Ayushman Bharat
18
The Lancet Praises the PM Modiโ€™s
Health care vison to 1.3 Billion Indians
๏ต Richard Horton, editor-in-
chief of the 'The Lancet', said
the prime minister has
grasped the importance of
health not only as a natural
right of citizens, but also as a
political instrument to meet
the growing expectations of
India's emerging middle
class.
9/14/2018Dr.T.V.Rao MD @Ayushman Bharat
19
Benefits to the poor
health minister explains
๏ต While speaking of the scheme, the
Health Minister stated that โ€œThis will give
underprivileged families the financial
support required when faced with
illnesses requiring hospitalisation.โ€
Health expenditure is one of the major
causes of poverty in India. It is seen that
close to seven percent of the
population is pushed into poverty every
year due to healthcare expenditure.
The scheme is expected to bring in
price-checks as well.
9/14/2018Dr.T.V.Rao MD @Ayushman Bharat
20
WHAT LANCET SAYS
๏ต Ayushman Bharat has two pillars
-- the creation of 1,50,000 health
and wellness centers across the
country to provide a spine of
primary care facilities to deliver
universal health coverage; and
the National Health Protection
Mission (NHPM), a health
insurance aimed at providing
coverage of Rs 5 lakh per family
annually, thus benefiting more9/14/2018Dr.T.V.Rao MD @Ayushman Bharat
21
WHAT LANCET SAID
๏ต While India is engulfed in this swirling
epidemic of non-communicable diseases,
the country is also in the grip of a mental
health emergency. India could claim 18 per
cent of the world's population in 2016, yet it
accounted for 37 per cent of global suicide
deaths among women and 24 per cent
among men,
๏ต PROGRAM PLANNED WITH
VISON TO OVER COME THE NEW
CHALLEGENS IN HEALTH SECTOR
9/14/2018Dr.T.V.Rao MD @Ayushman Bharat
22
The Lancet Says
๏ต Richard Horton, editor-in-
chief of the 'The Lancet',
said the prime minister has
grasped the importance of
health not only as a
natural right of citizens, but
also as a political
instrument to meet the
growing expectations of
India's emerging middle
class. 9/14/2018Dr.T.V.Rao MD @Ayushman Bharat
23
BENEFITING THE CRORES POOR
INDIANS
9/14/2018Dr.T.V.Rao MD @Ayushman Bharat
24
9/14/2018Dr.T.V.Rao MD @Ayushman Bharat
25
LET US ALL JOIN THE
MODIVISON MAKE INIDA
RICH HEALTHY
26
9/14/2018
Dr.T.V.RaoMD@AyushmanBharat
Resources and
References
๏ตAyushman Bharat Yojana
Government resources
๏ตThe Lancet
๏ตGoogle web resources on Ayushman
Bharat Yojana
9/14/2018Dr.T.V.Rao MD @Ayushman Bharat
27
๏ต The Ayushman Bharat Yojana program file created
by Dr.T.V.Rao MD in support of the great efforts of
Hon Prime Minister, Health Minister and Finance
minister to benefit poor underprivileged Indians to
get the equal resources for better health care
๏ต Email
๏ต doctortvrao@gmail.com
9/14/2018Dr.T.V.Rao MD @Ayushman Bharat
28

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Ayushman Bharat Yojana National Health Protection Scheme

  • 1. Ayushman Bharat Yojana National Health Protection Scheme DR.T.V.RAO MD 1
  • 2. ๏ต Ayushman Bharat Yojana will be launched on 25 September 2018. Beneficiaries will receive Ayushman Bharat Family Health Cards The key stakeholders in the scheme besides the consumers or beneficiaries are the Healthcare Providers, state governments and Insurance companies without whose support and involvement the execution of this scheme cannot happen. 2 Dr.T.V.Rao MD @Ayushman Bharat 9/14/2018
  • 3. PM MODIS VISION TO INDIA FOR EMPOWERING THE LIVES OF INDIANS 9/14/2018Dr.T.V.Rao MD @Ayushman Bharat 3
  • 4. BETTER HEALTH A UNIVERSAL DEMAND Ayushman Bharat Yojana fulfills the demand 4 Dr.T.V.Rao MD @Ayushman Bharat
  • 5. Health Minister, JP Nadda, stated ๏ต The Health Minister, JP Nadda, stated that the government is set to allocate 100 billion Rupees ($1.54 billion) for its ambitious health Programme, the Ayushman Bharatโ€“ National Health Protection Mission. Being dubbed as the largest public health scheme in the world, it is expected to be funded by both the central and state governments every year. 9/14/2018Dr.T.V.Rao MD @Ayushman Bharat 5
  • 6. Ayushman Bharat Programme VISON TO HEALTHY INDIA ๏ต The Government today announced two major initiatives in health sector , as part of Ayushman Bharat Programme. The Union Minister for Finance and Corporate Affairs, Shri Arun Jaitely while presenting the General Budget 2018-19 in Parliament here today said that this was aimed at making path breaking interventions to address health holistically, in primary, secondary and tertiary care systems, covering both prevention and health promotion. 9/14/2018Dr.T.V.Rao MD @Ayushman Bharat 6
  • 7. FEATURES OF Ayushman Bharat ๏ต Ayushman Bharat - National Health Protection Mission will have a defined benefit cover of Rs. 5 lakh per family per year. ๏ต Benefits of the scheme are portable across the country and a beneficiary covered under the scheme will be allowed to take cashless benefits from any public/private empanelled hospitals across the country. ๏ต Ayushman Bharat - National Health Protection Mission will be an entitlement based scheme with entitlement decided on the basis of deprivation criteria in the SECC database. ๏ต The beneficiaries can avail benefits in both public and empanelled private facilities. ๏ต To control costs, the payments for treatment will be done on package rate (to be defined by the Government in advance) basis. 9/14/2018Dr.T.V.Rao MD @Ayushman Bharat 7
  • 8. FEATURES OF Ayushman Bharat ๏ต One of the core principles of Ayushman Bharat - National Health Protection Mission is to co-operative federalism and flexibility to states. ๏ต For giving policy directions and fostering coordination between Centre and States, it is proposed to set up Ayushman Bharat National Health Protection Mission Council (AB-NHPMC) at apex level Chaired by Union Health and Family Welfare Minister. ๏ต States would need to have State Health Agency (SHA) to implement the scheme. ๏ต To ensure that the funds reach SHA on time, the transfer of funds from Central Government through Ayushman Bharat - National Health Protection Mission to State Health Agencies may be done through an escrow account directly. ๏ต In partnership with NITI Aayog, a robust, modular, scalable and interoperable IT platform will be made operational which will entail a paperless, cashless transaction. 9/14/2018Dr.T.V.Rao MD @Ayushman Bharat 8
  • 9. BRINGING IN BILLION CHEERS TO EVERY INDIAN 9/14/2018Dr.T.V.Rao MD @Ayushman Bharat 9
  • 10. BRINING AFFORDABLE HEALTH CARE TO BILLION CITIZENS OF INDIA 9/14/2018Dr.T.V.Rao MD @Ayushman Bharat 10
  • 11. IMPLEMENTATION STRATEGY ๏ต At the national level to manage, an Ayushman Bharat National Health Protection Mission Agency (AB- NHPMA) would be put in place. States/ UTs would be advised to implement the scheme by a dedicated entity called State Health Agency (SHA). They can either use an existing Trust/ Society/ Not for Profit Company/ State Nodal Agency (SNA) or set up a new entity to implement the scheme. 9/14/2018Dr.T.V.Rao MD @Ayushman Bharat 11
  • 12. HOW TO IMPLEMENT ๏ต States/ UTs can decide to implement the scheme through an insurance company or directly through the Trust/ Society or use an integrated model. 9/14/2018Dr.T.V.Rao MD @Ayushman Bharat 12
  • 14. Major Impact ๏ต Ayushman Bharat - National Health Protection Mission will have major impact on reduction of Out of Pocket (OOP) expenditure on ground of: ๏ต Increased benefit cover to nearly 40% of the population, (the poorest & the vulnerable) ๏ต Covering almost all secondary and many tertiary hospitalizations. (except a negative list) ๏ต Coverage of 5 lakh for each family, (no restriction of family size) 9/14/2018Dr.T.V.Rao MD @Ayushman Bharat 14
  • 15. Major Impact ๏ต This will lead to increased access to quality health and medication. In addition, the unmet needs of the population which remained hidden due to lack of financial resources will be catered to. This will lead to timely treatments, improvements in health outcomes, patient satisfaction, improvement in productivity and efficiency, job creation thus leading to improvement in quality of life. 9/14/2018Dr.T.V.Rao MD @Ayushman Bharat 15
  • 16. EXPENDITURE INVOLVED ๏ต The expenditure incurred in premium payment will be shared between Central and State Governments in specified ratio as per Ministry of Finance guidelines in vogue. The total expenditure will depend on actual market determined premium paid in States/ UTs where Ayushman Bharat - National Health Protection Mission will be implemented through insurance companies. In States/ UTs where the scheme will be implemented in Trust/ Society mode, the central share of funds will be provided based on actual expenditure or premium ceiling (whichever is lower) in the pre-determined ratio. 9/14/2018Dr.T.V.Rao MD @Ayushman Bharat 16
  • 17. NUMBER OF BENEFICIARIES ๏ต Ayushman Bharat - National Health Protection Mission will target about 10.74 crore poor, deprived rural families and identified occupational category of urban workers' families as per the latest Socio-Economic Caste Census (SECC) data covering both rural and urban. The scheme is designed to be dynamic and aspirational and it would take into account any future changes in the exclusion/ inclusion/ deprivation/ occupational criteria in the SECC data 9/14/2018Dr.T.V.Rao MD @Ayushman Bharat 17
  • 18. STATES/DISTRICTS COVERED ๏ต Ayushman Bharat - National Health Protection Mission will be rolled out across all States/UTs in all districts with an objective to cover all the targeted beneficiaries. 9/14/2018Dr.T.V.Rao MD @Ayushman Bharat 18
  • 19. The Lancet Praises the PM Modiโ€™s Health care vison to 1.3 Billion Indians ๏ต Richard Horton, editor-in- chief of the 'The Lancet', said the prime minister has grasped the importance of health not only as a natural right of citizens, but also as a political instrument to meet the growing expectations of India's emerging middle class. 9/14/2018Dr.T.V.Rao MD @Ayushman Bharat 19
  • 20. Benefits to the poor health minister explains ๏ต While speaking of the scheme, the Health Minister stated that โ€œThis will give underprivileged families the financial support required when faced with illnesses requiring hospitalisation.โ€ Health expenditure is one of the major causes of poverty in India. It is seen that close to seven percent of the population is pushed into poverty every year due to healthcare expenditure. The scheme is expected to bring in price-checks as well. 9/14/2018Dr.T.V.Rao MD @Ayushman Bharat 20
  • 21. WHAT LANCET SAYS ๏ต Ayushman Bharat has two pillars -- the creation of 1,50,000 health and wellness centers across the country to provide a spine of primary care facilities to deliver universal health coverage; and the National Health Protection Mission (NHPM), a health insurance aimed at providing coverage of Rs 5 lakh per family annually, thus benefiting more9/14/2018Dr.T.V.Rao MD @Ayushman Bharat 21
  • 22. WHAT LANCET SAID ๏ต While India is engulfed in this swirling epidemic of non-communicable diseases, the country is also in the grip of a mental health emergency. India could claim 18 per cent of the world's population in 2016, yet it accounted for 37 per cent of global suicide deaths among women and 24 per cent among men, ๏ต PROGRAM PLANNED WITH VISON TO OVER COME THE NEW CHALLEGENS IN HEALTH SECTOR 9/14/2018Dr.T.V.Rao MD @Ayushman Bharat 22
  • 23. The Lancet Says ๏ต Richard Horton, editor-in- chief of the 'The Lancet', said the prime minister has grasped the importance of health not only as a natural right of citizens, but also as a political instrument to meet the growing expectations of India's emerging middle class. 9/14/2018Dr.T.V.Rao MD @Ayushman Bharat 23
  • 24. BENEFITING THE CRORES POOR INDIANS 9/14/2018Dr.T.V.Rao MD @Ayushman Bharat 24
  • 26. LET US ALL JOIN THE MODIVISON MAKE INIDA RICH HEALTHY 26 9/14/2018 Dr.T.V.RaoMD@AyushmanBharat
  • 27. Resources and References ๏ตAyushman Bharat Yojana Government resources ๏ตThe Lancet ๏ตGoogle web resources on Ayushman Bharat Yojana 9/14/2018Dr.T.V.Rao MD @Ayushman Bharat 27
  • 28. ๏ต The Ayushman Bharat Yojana program file created by Dr.T.V.Rao MD in support of the great efforts of Hon Prime Minister, Health Minister and Finance minister to benefit poor underprivileged Indians to get the equal resources for better health care ๏ต Email ๏ต doctortvrao@gmail.com 9/14/2018Dr.T.V.Rao MD @Ayushman Bharat 28