Arogya mitras – the backbone of Ayushman Bharat scheme

An army of 6000 people across 31 states and union territories will act as facilitators in empanelled hospitals to ensure smooth functioning of the world’s largest public health insurance cover for the poor and vulnerable which Prime Minister Narendra Modi launched on Sunday.

The National Skill Development Corporation is simultaneously utilising Pradhan Mantri Kaushal Kendra and other Skill Development centres under the Ministry of Skill Development and Entrepreneurship Skill India Framework to train these people called Arogya Mitras to run Ayushman Bharat - Pradhan Mantri Jan Arogya Yojna (AB-PMJAY) smoothly.

The government has an ambitious target to have 100,000 arogya mitras by the end of this year. Each empanelled public and private hospital will have at least one arogya mitra to provide support in beneficiary verification, authentication, query management, grievance redressal and handling emergency cases.

Thirty states and Union territories have signed the memorandum of understanding with the Centre for the implementation of the scheme, and all government hospitals and health centres in these states are empanelled by default to start the scheme that offers cashless annual Rs 5lakh insurance per eligible family.

The arogya mitras will be the backbone of the scheme as they are comprehensively trained in software use, patient registration and interaction.

A pilot testing began in 16 states and Union territories from August 15 to check the functioning of software used in the scheme - one for beneficiary identification and another for financial transaction management.

Patients visiting government hospitals were being randomly tested to check software functioning.

“The first step was to identify the beneficiary; if the person showing up in our list was the same person who was eligible to avail of the scheme benefits. After we certified the beneficiary, the system generated a unique QR (quick recognition) code and the person got added to our golden list,” said Indu Bhushan, CEO, Ayushman Bharat.

The software will also have the complete record of patients from their admission to treatment, medicines given and discharge summary to their feedback, There will be a Rs 5 lakh wallet for each beneficiary, and the amount will get automatically deducted.

Tara Devi from Rudraprayag in Uttarakhand was the first beneficiary to have been successfully registered under the ‘golden list’ and a woman who delivered a baby girl in Haryana, was the first beneficiary of the scheme.

The number of people expected to benefit from the scheme is 50 crore, which is nearly 40% of country’s population, and will gradually be expanded to the other citizens.

To rein in corrupt practices, patients will have to seek a referral from a government hospital for treatment in a private hospital. This will be a portable scheme, so a patient registered in one state can get treated in some other state.

The budget for the scheme is estimated to be Rs 10,000 crore for two years. The Centre will be contributing 60% of the cost, 90% for north eastern states and 100% for the Union territories.

Twenty two states have opted for the trust model, thus reducing dependence on private insurance companies. The premium has been estimated to be Rs 1100 annually per family.

The government has also framed guidelines to prevent, detect and deter fraud in the implementation of the scheme.

“We have ensured a strict data protection mechanism that has 94 control tools at various levels that are based on international best practices and tweaked according to India-specific regulations. The data and information is absolutely secure,” said JP Nadda, Union health minister.

“Training and testing is an ongoing process. We have first time launched something this big; we will be learning and correcting the problems as we go,” he said.

[https://www.hindustantimes.com/india-news/arogya-mitras-the-backbone-of-ayushman-bharat-scheme/story-dY6gHw1qlrQ8XNy2yeywSK.html Sep 24, 2018]