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Over 1,700 hospitals aim to join state’s apex health scheme – ET HealthWorld

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Mumbai: Over 1,700 hospitals, ranging from small to mid-level, are seeking to join the state’s flagship health scheme, Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY). The state recently announced its intention to expand the quota of participating hospitals from 1,000 to 1,200, intensifying the competition.

While the state has portrayed the hospitals’ eagerness as a sign of the scheme’s success and widespread impact, industry insiders suggest a different motivation. Sources said several hospitals perceive the scheme as a lucrative revenue stream, with annual earnings ranging from Rs 20 lakh to Rs 5 crore from treating patients under its coverage.

In this year’s budget, the state made an announcement stating that treatment limit for each family per year would be increased from Rs 1.50 lakh to Rs 5 lakh. Additionally, government said 200 new hospitals will be included in the scheme to expand its reach. While the financial approvals for the expansion are yet to come, the online applications have been pouring in, said Vinod Bondre, acting CEO of MJPJAY.

Of the existing fixed quota of 1,000 hospitals, 272 are government and the remaining private. Bondre said hospitals frequently join and exit the scheme. However, ever since the state announced plans to expand the scheme, there has been a notable surge of interest from hospitals.

Since its establishment in 2012, the scheme has taken action against 641 hospitals for refusing treatment to patients or levying unauthorized charges. In some cases, hospitals themselves have chosen to withdraw. “All new entrants will undergo scrutiny by a committee followed by a physical inspection before being approved for empanelment,” said Bondre.

Interestingly, hospitals that are part of the scheme have a word of caution for enthusiasts. “Many who are in the scheme are desperate to leave but they cannot due to pending dues,” said a hospital head, adding that there are glaring operational challenges that the government is unwilling to address.

A year ago, more than 300 hospitals that are a part of the scheme came together under the Hospital Welfare Association (HWA). According to Dr Himanshu Gupta from Aurangabad, who is a member of the HWA and part of the scheme since the beginning, MJPJAY benefits smaller hospitals but lacks viability for mid-level or multi-speciality hospitals. He pointed out a discrepancy: small hospitals can refer patients for tests outside the facility, allowing them 20-25 per cent out-of-pocket expense. However, multi-speciality hospitals are penalised if patients pay for even a single test.

  • Published On May 17, 2023 at 10:53 AM IST

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