Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY): In Quest of Providing Accessible, Affordable & Quality Solutions to Achieve Universal Healthcare

Abstract

Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana is a flagship scheme of the Government of India, with a vision of Universal Health Coverage (UHC) as its underlying commitment of "leaving no one behind." Launched in 2018, AB-PMJAY is the world’s largest health assurance scheme, aiming at providing a health cover for secondary and tertiary care hospitalization to over 12 crores poor and vulnerable families. With more than 42.7 crore Ayushman cards created across the country, and 32,500 empanelled hospitals, the AB-PMJAY scheme is currently providing cashless healthcare services for 1,961 procedures across 27 medical specialities. AB-PMJAY scheme has been evolving since its inception and is constantly adding new features in its portfolio, such as coverage of 70+ population; shift from volume-based to value-based care system, strengthening of district implementation units, to name a few. The scheme has many achievements, however, there are gaps and irregularities in the current disposition. The article outlines these gaps and gives pragmatic solutions to fill those loopholes. Filling these critical gaps is critical before the programme goes on to the next level, in terms of coverage without compromising on the quality of care.