Ayushman Bharat-PMJAY revised Health Benefit Packages (HBP 2.0) may soon be implemented in several states across the country. National Health Authority, the nodal agency for implementation of this AB-PMJAY, today said that a pilot of HBP 2.0 has been completed in Nagaland and many states have shown interest in migrating to the revised packages. “A pilot of HBP 2.0 has already been completed in the state of Nagaland. Many states have shown interest in migrating to HBP 2.0. NHA is working closely with SHAs to ensure that the migration of these states from HBP 1.0 to HBP 2.0 is done smoothly without any major hiccups. It is expected that within next few months, all the states would have migrated to HBP 2.0,” NHA said.
NHA said that the revised oncology packages in HBP 2.0 will revamp cancer care for beneficiaries. They are “aligned to reflect the current best practices in the country.”
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“A conscious attempt has been made to standardize the nomenclature and definitions of the packages. NHA, in collaboration with World Health Organization (WHO), has initiated the process of aligning the HBP with International Classification of Health Interventions (ICHI) and International Classification of Diseases (ICD 11) coding of the WHO. Several innovative concepts were devised by NHA while revising the packages such as cross specialty packages, stratified packages and add-on packages which will enhance the ease of selecting the right package for the empaneled hospital,” it said.
The health benefit packages under Ayushman Bharat-PMJAY were revised in September last year. Under the revision, rates of 270 packages were increased, 237 new packages were added, 218 stratified packages were adopted. There was no change in the rate of 469 packages. “The highlight of the changes is that without compromising the range of treatment covered under PM-JAY, 554 packages have been discontinued and there is a reduction in the rate of 57 packages. Overall, a conscious attempt has been made to keep the price of abuse prone packages at the minimum level to minimize incentives for abuse,” NHA said.
PMJAY HBP 1.0 vs PMJAY HBP 2.0
In HBP 1.0, PMJAY had 1,393 treatment packages out of which 1,083 were surgical, 309 medical and 1 unspecified package whereas in HBP 2.0 the scheme has 872 treatment packages with 1,578 procedures out of which 612 surgical packages contain 1052 procedures and 260 medical packages contain 526 treatments.
“NHA is confident that with the launch of HBP 2.0, the concerns of various stakeholders will be addressed, more private hospitals will get empaneled and more poor beneficiaries will be able to avail of their entitlements. This will take India one step closer towards its goal of Universal Health Coverage,” the health authority said.