Lok Sabha Question No. 3134 (UNSTARRED), answered on 2024-12-13
Subject: Implementation of Ayushman Bharat in Punjab
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Shri Amrinder Singh Raja Warring

## GOVERNMENTOFINDIA MINISTRYOF HEALTH AND FAMILYWELFARE DEPARTMENTOFHEALTH AND FAMILYWELFARE

## LOK SABHA UNSTARRED QUESTION NO. 3134 TO BE ANSWERED ON 13 TH DECEMBER, 2024

## IMPLEMENTATION OFAYUSHMAN BHARAT IN PUNJAB

## 3134. SHRIAMRINDERSINGHRAJAWARRING:

Will the Minister of HEALTHAND FAMILYWELFARE be pleased to state:

- (a) the number of beneficiaries treated under Ayushman Bharat against the number of total individuals covered under the scheme during the last five years, in the State of Punjab;
- (b) the details of private hospitals where the benefits of Ayushman Bharat are availed in the State of Punjab, district-wise;
- (c) whether there has been any study report sponsored by the Government to study the effectiveness of the scheme, if so, the details thereof;
- (d) the details of the major issues identified for the successfully implementation of the Ayushman Bharat along with the corrective steps taken/proposed to be taken by the Government to resolve those issues; and
- (e) the details of the contribution of the Union and State Government to Ayushman Bharat Scheme during the last three financial years indicating the ratio and exact amount contributed?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI PRATAPRAO JADHAV)

- (a): In the State of Punjab, a total of 45 lakh beneficiary families corresponding to 1.97 crore individuals are covered under Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (ABPMJAY). In the last five years, a total of 19.87 lakh hospital admissions worth over Rs. 2,490.35 crore have been authorized under the scheme in the state of Punjab.

(b): District-wise details of private hospitals empaneled under AB-PMJAY in the State of Punjab can be accessed through the following link:

https://hospitals.pmjay.gov.in/Search/empnlWorkFlow.htm?actionFlag=ViewRegisteredHosptlsN ew

(c): A baseline study was commissioned by the Government of India in 2019-2020 to understand the impact of AB-PMJAY across the States of Bihar, Chhattisgarh, Gujarat, Kerala, Meghalaya, Tamil Nadu and Uttar Pradesh covering a sample of 72,636 individuals.

The study observed that AB-PMJAY, since its early implementation period, has been instrumental in increasing access to health care and in reducing Out Of Pocket Expenditures (OOPE) among beneficiaries who need highly specialized care. Qualitative analysis of the study also revealed that beneficiaries are satisfied with the quality of medical services received under AB-PMJAY. The study inter-alia recommended strategies to increase awareness of the scheme, addressing barriers in accessing healthcare services to ensure that beneficiaries receive specialized care timely, replicating experiences from other settings like dedicated staff to guide and assist beneficiaries, establishing communication and feedback channels to allow beneficiaries to voice their concerns.

(d): Some of the focus areas for effective implementation of the scheme are as follows:

## 1. Beneficiary base expansion

The beneficiary base of the scheme has been continuously progressing from 10.74 crore SECC/RSBY families to 12 crore poor and vulnerable families in January 2022. States/UTs have been given the flexibility to use other databases for verification of beneficiaries against such SECC beneficiaries who could not be identified and verified. The beneficiary base has been further expanded by including 37 lakh Accredited Social Health Activist (ASHAs) / Anganwadi Workers (AWWs) / Anganwadi Helpers (AWHs) and their families in February 2024. Additionally, approximately 6 crore senior citizens of the age 70 years and above (corresponding to approximately 4.5 crore families) have been brought under the ambit of the scheme in October 2024.

## 2. IT system improvisation

- i. Beneficiary Identification System (BIS 2.0) allows self / assisted verification and eliminates unnecessary intermediaries.
- ii. Beneficiary verification and card creation have been enabled on 'Ayushman' mobile application equipped with face-authentication technology.
- iii. Transaction Management System (TMS 2.0) has been launched to improve in-patient registration, pre-authorization, admission, initial diagnosis, follow up, claims management and payments.
- iv. User Management Portal (UMP) aims to facilitate the users to access the various PMJAYapplications through the single ID and password with a single sign-on facility.
- v. National portal, dashboard & analytical solution to monitor the status of implementation of AB-PMJAY on Key Performance Indicators (KPIs), generate reports, identify trends and further feed data for grievance and fraud analysis.

## 3. Awareness generation

Campaigns like "Aapke Dwar Ayushman" have been undertaken to mobilize millions. Beneficiary empowerment efforts include partnerships with grassroots workers, initiatives like Ayushman Mitra and the issuance of Adhikar and Abhinandan Patras to inform and engage beneficiaries. Awareness campaigns leverage diverse media platforms to disseminate information.

(e): Ayushman Bharat - Pradhan Mantri-Jan Arogya Yojana (AB-PMJAY) is completely funded by the Government and the costs are shared between Central and State Governments as per the existing policy of the scheme. The ratio of Central share to State share in the State of Punjab is 60:40. Central Government's share of Grant-in-Aid is based on the above sharing pattern ratio for the actual cost of treatment of the scheme beneficiary families or maximum ceiling amount decided by Government of India (presently Rs. 1052 per family per year), whichever is less. As of now, any additional expenditure over and above the maximum ceiling amount has to be borne by the State Government as per the current applicable guidelines.

The funding of AB-PMJAY is entirely demand driven. Funds are released to the States/UTs on the basis of the actual demand received from them. There is no State/UT-wise allocation of funds. As per the defined process, States/UTs are required to furnish the Utilization Certificate of previously received funds prior to every new fund release.

In the State of Punjab, AB-PMJAY is implemented in convergence with the State's own health assurance scheme. The total number of eligible families overall is 45 lakh. Out of these, 16.65 lakh families are supported by both Central and State governments. The remaining families are supported under the State scheme and the treatment cost for these families is borne by the State government. The details of central share of funds released to the State of Punjab under ABPMJAYfor the last three years are at Annexure .

## Details of central share of funds released to the State of Punjab under AB-PMJAY since inception of scheme

(in crore of Rupees)

| Financial Year   |   Central share of funds released for AB-PMJAYfamilies |
|------------------|--------------------------------------------------------|
| 2021-22          |                                                  80.5  |
| 2022-23          |                                                 111.38 |
| 2023-24          |                                                  57.96 |

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