IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0251814.html
   My bibliography  Save this article

Empanelment of health care facilities under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) in India

Author

Listed:
  • Jaison Joseph
  • Hari Sankar D.
  • Devaki Nambiar

Abstract

Introduction: India’s Pradhan Mantri Jan Arogya Yojana (PM-JAY) is the world’s largest health assurance scheme providing health cover of 500,000 INR (about USD 6,800) per family per year. It provides financial support for secondary and tertiary care hospitalization expenses to about 500 million of India’s poorest households through various insurance models with care delivered by public and private empanelled providers. This study undertook to describe the provider empanelment of PM-JAY, a key element of its functioning and determinant of its impact. Methods: We carried out secondary analysis of cross-sectional administrative program data publicly available in PM-JAY portal for 30 Indian states and 06 UTs. We analysed the state wise distribution, type and sector of empanelled hospitals and services offered through PM-JAY scheme across all the states and UTs. Results: We found that out of the total facilities empanelled (N = 20,257) under the scheme in 2020, more than half (N = 11,367, 56%) were in the public sector, while 8,157 (40%) facilities were private for profit, and 733 (4%) were private not for profit entities. State wise distribution of hospitals showed that five states (Karnataka (N = 2,996, 14.9%), Gujarat (N = 2,672, 13.3%), Uttar Pradesh (N = 2,627, 13%), Tamil Nadu (N = 2315, 11.5%) and Rajasthan (N = 2,093 facilities, 10.4%) contributed to more than 60% of empanelled PMJAY facilities: We also observed that 40% of facilities were offering between two and five specialties while 14% of empanelled hospitals provided 21–24 specialties. Conclusion: A majority of the hospital empanelled under the scheme are in states with previous experience of implementing publicly funded health insurance schemes, with the exception of Uttar Pradesh. Reasons underlying these patterns of empanelment as well as the impact of empanelment on service access, utilisation, population health and financial risk protection warrant further study. While the inclusion and regulation of the private sector is a goal that may be served by empanelment, the role of public sector remains critical, particularly in underserved areas of India.

Suggested Citation

  • 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.
    • Handle: RePEc:plo:pone00:0251814
    DOI: 10.1371/journal.pone.0251814
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0251814
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0251814&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0251814?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Mita Choudhury & Pritam Datta, 2019. "Private Hospitals in Health Insurance Network in India: A Reflection for Implementation of Ayushman Bharat," Working Papers id:13009, eSocialSciences.
    2. 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.
    3. Government of India, 2017. "National Health Policy 2017," Working Papers id:11664, eSocialSciences.
    4. Gerard La Forgia & Somil Nagpal, 2012. "Government-Sponsored Health Insurance in India : Are You Covered?," World Bank Publications - Books, The World Bank Group, number 11957.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. S S Ramya & Rebecca Devaprasad, 2023. "An Investigation into the Implementation Approaches of the Pradhan Mantri Jan Arogya Yojana in Four South Indian States," Shanlax International Journal of Economics, Shanlax Journals, vol. 11(4), pages 1-9, September.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. 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.
    2. 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.
    3. Motkuri, Venkatanarayana & Khan, Amir Ullah, 2018. "Macro Economy and Health in India," MPRA Paper 84512, University Library of Munich, Germany.
    4. 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.
    5. Dayashankar Maurya & Altaf Virani & S. Rajasulochana, 2017. "Horses for Courses: Moving India towards Universal Health Coverage through Targeted Policy Design," Applied Health Economics and Health Policy, Springer, vol. 15(6), pages 733-744, December.
    6. Tajul Masron & Mduduzi Biyase & Talent Zwane & Thomas Udimal & Frederich Kirsten, 2023. "Ecological footprint and population health outcomes: an analysis of E7 countries," Economics Working Papers edwrg-07-2023, College of Business and Economics, University of Johannesburg, South Africa, revised 2023.
    7. Shawhan, Daniel L. & Picciano, Paul D., 2019. "Costs and benefits of saving unprofitable generators: A simulation case study for US coal and nuclear power plants," Energy Policy, Elsevier, vol. 124(C), pages 383-400.
    8. Shu Yan & Lizi Pan & Yan Lu & Juan Chen & Ting Zhang & Dongzi Xu & Zhaolian Ouyang, 2023. "Towards Sustainable Drug Supply in China: A Bibliometric Analysis of Drug Reform Policies," Sustainability, MDPI, vol. 15(13), pages 1-20, June.
    9. Bozena Wielgoszewska & Alex Bryson & Monica Costa-Dias & Francesca Foliano & Heather Joshi & David Wilkinson, 2021. "Exploring the Reasons for Labour Market Gender Inequality a Year into the Covid-19 Pandemic: Evidence from the UK Cohort Studies," DoQSS Working Papers 21-23, Quantitative Social Science - UCL Social Research Institute, University College London.
    10. Shi, Wunan & Wouters, Olivier J. & Liu, Gordon & Mossialos, Elias & Yang, Xiuyun, 2020. "Association between provincial income levels and drug prices in China over the period 2010–2017," Social Science & Medicine, Elsevier, vol. 263(C).
    11. Manuela De Allegri & Swati Srivastava & Christoph Strupat & Stephan Brenner & Divya Parmar & Diletta Parisi & Caitlin Walsh & Sahil Mahajan & Rupak Neogi & Susanne Ziegler & Sharmishtha Basu & Nishant, 2020. "Mixed and Multi-Methods Protocol to Evaluate Implementation Processes and Early Effects of the Pradhan Mantri Jan Arogya Yojana Scheme in Seven Indian States," IJERPH, MDPI, vol. 17(21), pages 1-15, October.
    12. Katie Adamek & Sarah Bardin & So O'Neil & Dara Lee Luca, "undated". "Accelerating Teen Pregnancy Prevention in Phillips County, Arkansas and Coahoma County, Mississippi," Mathematica Policy Research Reports 7fda86cbb1bf4303a84f466e8, Mathematica Policy Research.
    13. Han, Lu & Koenig-Archibugi, Mathias & Opsahl, Tore, 2018. "The social network of international health aid," Social Science & Medicine, Elsevier, vol. 206(C), pages 67-74.
    14. Chatterjee, Chirantan & Kubo, Kensuke & Pingali, Viswanath, 2015. "The consumer welfare implications of governmental policies and firm strategy in markets for medicines," Journal of Health Economics, Elsevier, vol. 44(C), pages 255-273.
    15. Burieva Nigora Hasanovna, 2019. "Models of Financing and Organization of Health Care System-International Experience," International Journal of Management Science and Business Administration, Inovatus Services Ltd., vol. 5(5), pages 7-12, July.
    16. Carolina Cortes-Herrera & Graciela Artavia & Silvia Quiros-Fallas & Eduardo Calderon-Calvo & Astrid Leiva & Josue Vasquez-Flores & Fabio Granados-Chinchilla, 2023. "Analysis of Minerals in Foods: A Three-year Survey from Costa Rican Market Products," Journal of Food Research, Canadian Center of Science and Education, vol. 12(1), pages 1-9, January.
    17. Victoria S S Wong & Lauro Nathaniel Avalos & Michael L Callaham, 2019. "Industry payments to physician journal editors," PLOS ONE, Public Library of Science, vol. 14(2), pages 1-11, February.
    18. Ya-Ling Lin & Wen-Yi Chen & Shwn-Huey Shieh, 2020. "Age Structural Transitions and Copayment Policy Effectiveness: Evidence from Taiwan’s National Health Insurance System," IJERPH, MDPI, vol. 17(12), pages 1-17, June.
    19. Kyeong-Rae Kim & Jae-Eun Park & So-Young Lim & Ho Kim & Il-Tae Jang & Kwang-Yeol Lee, 2020. "Effects of Nutrition on Osteoarthritis in Women Over the 50 Years: Using the Korea National Health and Nutrition Examination Survey (KNHANES) Data," Global Journal of Health Science, Canadian Center of Science and Education, vol. 12(7), pages 1-29, June.
    20. Robert John Kolesar & Peter Bogetoft & Vanara Chea & Guido Erreygers & Sambo Pheakdey, 2022. "Advancing universal health coverage in the COVID-19 era: an assessment of public health services technical efficiency and applied cost allocation in Cambodia," Health Economics Review, Springer, vol. 12(1), pages 1-20, December.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0251814. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.