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Private Hospitals in Health Insurance Network in India: A Reflection for Implementation of Ayushman Bharat

Author

Listed:
  • Choudhury, Mita

    (National Institute of Public Finance and Policy)

  • Datta, Pritam

    (National Institute of Public Finance and Policy)

Abstract

Private hospitals are expected to play a key role in the implementation of govern-ment sponsored health insurance schemes (GSHIS) in India. This paper examines the availability and spread of private hospitals in the country to provide insights on the po-tential access to insured health services in GSHIS schemes. It uses three sets of infor-mation to analyse the issue: private hospitals empanelled by insurance companies, the 6th Economic Census, and private hospitals empanelled in GSHIS schemes in four States. The analysis suggests that, in low-income States of the country, empanelment of private hos-pitals by insurance companies is low and concentrated in a few pockets. This pattern closely corresponds to the pattern of availability of private hospitals indicated in the 6th Economic Census. In Andhra Pradesh, Telangana, Tamil Nadu and Karnataka, the four States which have some of the largest GSHIS schemes in the country, there is a strong correspondence between private hospitals empanelled by insurance companies and pri-vate hospitals empanelled in GSHIS schemes. In these States, the extent of empanelment of private hospitals in GSHIS schemes is also substantially smaller than the empanelment of private hospitals by insurance companies. This may indicate differences in entry con-ditions or low willingness of private hospitals to participate in GSHIS schemes.

Suggested Citation

  • Choudhury, Mita & Datta, Pritam, 2019. "Private Hospitals in Health Insurance Network in India: A Reflection for Implementation of Ayushman Bharat," Working Papers 19/254, National Institute of Public Finance and Policy.
    • Handle: RePEc:npf:wpaper:19/254
    Note: Working Paper 254, 2019
    as

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    File URL: https://www.nipfp.org.in/media/medialibrary/2019/02/WP_254_2019.pdf
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    References listed on IDEAS

    as
    1. Shailender Kumar Hooda, 2015. "Private Sector in Healthcare Delivery Market in India: Structure, Growth and Implications," Working Papers 185, Institute for Studies in Industrial Development (ISID).
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    Cited by:

    1. Chakraborty, Lekha & Nayyar, Veena & Jain, Komal, 2019. "The Political Economy of Gender Budgeting: Empirical Evidence from India," Working Papers 19/256, National Institute of Public Finance and Policy.
    2. Anandita Sharma, 2023. "Social Health Protection and Publicly Funded Health Insurance Schemes in India: The Right Way Forward?," The Indian Journal of Labour Economics, Springer;The Indian Society of Labour Economics (ISLE), vol. 66(2), pages 513-534, June.
    3. Jaison Joseph & Hari Sankar D. & Devaki Nambiar, 2021. "Empanelment of health care facilities under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) in India," PLOS ONE, Public Library of Science, vol. 16(5), pages 1-16, May.
    4. Choudhury, Mita & Tripathi, Shruti & Dubey, Jay Dev, 2019. "Experiences with Government Sponsored Health Insurance Schemes in Indian States: A Fiscal Perspective," Working Papers 19/283, National Institute of Public Finance and Policy.

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    More about this item

    Keywords

    Private health providers ; Private hospitals; Ayushman Bharat ; Pradhan Man-tri Jan Arogya Yojana ; Access to health care ; India;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality

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