National Health Authority (NHA) is introducing a new system to measure and grade hospital performance under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana, aiming to focus on measuring the performance of hospitals from the volume of services provided to the value of healthcare services.
According to an official statement, the new initiative will introduce the concept of 'value-based care', where payment will be outcome-based and providers will be rewarded according to the quality of the treatment delivered.
"Under the new model, the providers will be rewarded for helping the patients improve their health, which consequently will reduce the effects of the disease in the population in the long term," the statement said.
"While the patients will get better health outcomes and higher satisfaction out of the services they receive, providers stand to get better care efficiencies. Similarly, payers will be able to maximize the health benefits generated out of the spending incurred," it added.
Speaking on the initiative Dr RS Sharma, CEO, National Health Authority said, "To ensure PM-JAY beneficiaries receive both cashless healthcare benefits and high-quality care at every empanelled hospital, NHA has implemented various measures. These measures include standardizing the cost of treatment under the scheme and adding new and advanced treatment procedures. Additionally, NHA has made a provision to incentivize best-performing hospitals that provide quality care to patients."
The statement said that under value-based care, the performance of AB PM-JAY empanelled hospitals will be measured based on five performance indicators such as Beneficiary Satisfaction; Hospital Readmission Rate; the extent of Out-of-Pocket Expenditure; confirmed Grievances and improvement in patient's Health-Related Quality of Life.
"The performance of the hospitals based on the above indicators shall also be made available on a public dashboard that will help the beneficiaries to make an informed decision. In this way, the hospital performance shall not only determine the financial incentive of the hospital but also create a demand for quality treatment of beneficiaries under PMJAY," it said.
( With inputs from ANI )
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