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Senior executives from some private hospitals met officials of Niti Aayog and health ministry on Friday over this issue following representations by various industry forums, sources said. “It appears that, overall, no scientific basis has been applied to arrive at the rates. Under these conditions, you may kindly appreciate that private healthcare providers would not be able to sustain themselves in providing quality healthcare unless the rates are reasonable and scientifically arrived at,” said a letter from Association of Healthcare Providers (India) to the CEO of Ayushman Bharat, Indu Bhushan.
However, the government maintains that it finalised the prices carefully. “The rates are decided nationally. We have also given states some flexibility to change the rates by up to 10%. Moreover, there are incentives for private players of up to 30%,” Bhushan said.
Niti Aayog member Dr VK Paul said the primary focus of the scheme is to make quality healthcare available in Tier-II and Tier-III cities. While the private hospitals will gain by volumes, they can undertake cost reduction by removing frills, added Paul. However, private healthcare providers do not agree. “For quality care we need to spend money. Some prices as fixed are too low and we have brought that to the notice of the government. I am hopeful that those prices will be revised,” said Dr Devi Shetty, Chairman, Narayana Health.
Dr Naresh Trehan of Medanta said the government should appoint an independent agency to evaluate and determine the pricing.
Some top executives from the industry told TOI that the government has hinted at a scope for revision in some rates where the prices fixed are too low. Prices of stents and replacement are being reconsidered, an executive said. Bhushan, however, maintained that the companies are yet to build a strong case for any revision.
The health ministry along with Niti Aayog finalised the rates for 1,354 packages that will be covered under the National Health Protection Scheme. TOI was the first to report that the scheme will offer common treatment such as coronary bypass, knee transplant and C-section at a rate that is around 15-20% lower than the Central Government Health Scheme (CGHS). Popularly known as Modicare, the scheme aims to cover nearly 50 crore beneficiaries from over 10.74 crore “deprived” families with an annual health cover of Rs 5 lakh per family.