Page 35 - Forbes - India (January 2020)

AyushMAN BhArAt

How can we do this? It’s totally according to a recent pan-India study
unviable. If anyone can do this, they Supply-side statistics by the Union Ministry of Statistics
should have 50 percent margins.” 18,236 hospitals were empanelled in the and Programme Implementation.
Forbes India interviewed more first 12 months of AB-PMJAY Ayushman Bharat offers a
than 20 C-suite executives, doctors Private Public measly `25,000 package. “This
and technicians working at private hospitals hospitals is a clear reflection that detailed
hospitals in metros and smaller 9,665 8,571 homework has really not been done,”
towns, most of whom spoke off the says Shrikhande, adding that the
record. They were unanimous in Whipples package offered by the
their view: AB-PMJAY is noble in 53% 47% Maharashtra government-funded
intent and they’d like to play a role MPJAY is much higher at `75,000.
is offering quality health care to the The latter, he says, is “not bad” as
less privileged, but at the present one can cross-subsidise the balance
package rates, it is unfeasible. amount from full-fee paying patients.
So which hospitals are carrying 71 percent of the private hospitals that have been However, patients might still have
out procedures under AB-PMJAY? empanelled are nursing homes with less than 25 beds to resort to catastrophic out-of-
According to official data, 53 percent Source AB-PMJAY Annual report 2018-19 pocket expenditure, he cautions.
of the 46.5 lakh treatments completed Add complications into the
as of September 2019 have been is widely regarded as one of the most mix, which happen in 30 percent
carried out by private players. Since complex operations, says Shrikhande, of the cases, he estimates, and
most of the large private hospitals referring to his area of specialisation. the economics just don’t work.
have stayed away from the scheme— Without complications, such a “You can’t expect Shiv Sagar
notable exceptions are Apollo surgery costs around `1-1.5 lakh at rates at JW Marriott,” says one
which has allocated about 5 percent the Tata Memorial Hospital. A for- private hospital executive.
of its bed capacity in tier 2 and 3 profit private hospital would charge “I’ve been told by officials that
towns for AB-PMJAY patients and between `3 lakh and `15 lakh for the they don’t really want hospitals 35
Narayana Hruduyalaya—what’s left same procedure. Government hospital from metros to come on board
are smaller hospitals and nursing rates tend to be about six times lower, the scheme,” says another head
homes. According to AB-PMJAY’s of a group of hospitals. “They’re
2018-19 annual report, of the 53 looking at hospitals in tier 2
percent treatments carried out by and 3 cities. Even then, I don’t
private players, 71 percent were done think the math works out.”
at hospitals with less than 25 beds. “It’s a myth that these rates are
“Packages are unrealistic,” says viable in tier 2 and 3 city hospitals,”
Dr Shailesh Shrikhande, head, says a doctor-cum-promoter
division of cancer surgery and deputy of a hospital chain in interior
director, Tata Memorial Hospital. Maharashtra. “Staff costs might be
“We are in a privileged position lower here, but it’s still loss-making
because our costs are anyway 30 to for us to treat patients at these rates.”
40 percent less than what a [for- To incentivise large hospitals to
profit] private hospital would charge set up shop in smaller towns, AB-
because of bulk buying of drugs and PMJAY is offering land at subsidised
equipment. We also receive a subsidy “rates can’t Be rates and also “viability gap funding”
from the Department of Atomic the saMe for an to support infrastructure building.
Energy [because of the radiation “We are considering such an option…
technology used in treatment],” he angioPlasty done in the success of the scheme relies on
explains. Tata Memorial treated a tier 2 city hosPital participation from the private sector,”
1,183 patients under the AB-PMJAY says Dr Ashok Seth, chairman of
scheme between January and and one done at Fortis Escorts Heart Institute.
November 2019; 48 percent of aiiMs or escorts.”
those claims have been settled. nee surgeries grew in popularity
Take, for instance, a surgery to dr aShOk Seth, Chairman, Fortis escorts when the procedure was included
treat pancreatic cancer or Whipples heart Institute k in the Gujarat government’s
as it’s known in medical parlance. It Mukhyamantri Amrutum health

january 31, 2020 • forbes india