Odisha: Private Hospitals Express Serious Concerns over Low Rates, Operational Challenges under Ayushman Bharat

Bhubaneswar: Private hospitals in Odisha have raised serious concerns about the implementation of the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and the state-run Gopabandhu Jan Arogya Yojana (GJAY), citing low reimbursement rates and operational challenges.

During an emergency meeting held at the Indian Medical Association (IMA) Institute in Bhubaneswar, the hospital CEOs and entrepreneurs voiced their grievances, warning of potential withdrawal from the schemes if issues remain unresolved.

The All Odisha Private Medical Establishment Forum (AOPMEF) highlighted multiple problems, including inefficient patient registration systems, cumbersome administrative processes, and inadequate rates for critical procedures like orthopedics, neurosurgery, and cardiac surgeries. Dr. Indramani Jena, AOPMEF Secretary, pointed out that while the cost of a pacemaker is at least Rs 1.5 lakh, AB-PMJAY reimburses only Rs 75,000, leaving hospitals financially strained. The lack of coverage for life-saving implants in specialties like gynecology and neurosurgery was also a major concern.

Hospital representatives further noted the burden of uploading extensive documentation, including photographs and reports, which complicates operations. They have issued a 15-day ultimatum to the government to address these issues, threatening to opt out of the schemes if corrective measures are not taken.

The standoff raises concerns about the accessibility of healthcare services under these flagship programs, potentially impacting thousands of beneficiaries in Odisha. The state government has yet to respond to the hospitals’ demands.