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Ayushman Bharat - A big leap towards Universal Health Coverage in India Ayushman Bharat — A big leap towards Universal Health Coverage in India December 2019 home.kpmg/in | a Ayushman Bharat - A big leap towards Universal Health Coverage in India b| © | 2019 KPMG, an Indian Registered Partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. Ayushman Bharat - A big leap towards Universal Health Coverage in India Foreword by ASSOCHAM President Over the years India has improved immensely Bharat Yojana would support building a New in health parameters such as life expectancy, India and ensure wellbeing of people,enhanced mortality rates, health & sanitation, productivity,prevent wage loss, reduce financial immunization, among others. However, the hardship, create jobsand boost the healthcare journey towards a healthier nation has only sector. partially been traversed.Indian healthcare For the implementation of the scheme, remainsbeset with challenges pertaining to suitable models are being considered with disparities in accessibility, affordability, quality the involvement of the private sector to healthcare services, infrastructure, funding, ensure widespread and effective reach of the which are creating increased pressure on the initiative. Such arrangements would focus on existing system. infrastructure development, service delivery, While urban areas,to an extent,have been able technologies, standardization of practices, to address some of these concernsin the form capacity building and economies of scale. This of emerging private healthcare institutions, would pave the way for a wider healthcare those most needy and underprivileged in marketplace with diversified product offerings, far-flung areas remain deprived of timely, encourage new market entrants in the wake of quality and affordable medical interventions. possible newer investment avenues. It is to bring these segments into the fold of Fostering a synergistic relationship between healthcare that the government had envisioned the public and private sector is key to achieving Universal Health Coverage. the vision of universal healthcare for our To effect the realization of Universal Health country and imparting the benefits of modern Coverage, the government introduced the medicine across all segments. While India Ayushman Bharat Yojana to bring the healthcare marches towards its ambitious economic services within the reach of the community. goals, the implementation of the Ayushman Considered as world’s biggest government Bharat Yojana would go a long way in balancing health programme, the scheme aims at economic and inclusive growth agendas. providing secondary and tertiary hospitalization to poor and economically vulnerablefamilies across the county, in addition to establishing wellness centres. A commendable and far- sighted initiative of our political leadership, the scheme is an important milestone for India, which would benefit from an elevation of the overall healthcare system. From the social development perspective, the initiative would bridge the disparity among various segments Balkrishan Goenka and improve the nation’s overall health indices. President, ASSOCHAM On other hand, the initiatives under Ayushman & Chairman, Welspun Group © 2019 KPMG, an Indian Registered Partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. | c | Ayushman Bharat - A big leap towards Universal Health Coverage in India Foreword by ASSOCHAM Secretary General Ayushman Bharat - Pradhan Mantri Jan KPMG study has pointed out, its success Arogya Yojana (PM-JAY) is one of the most would depend on pragmatic policy ambitious and life-changing schemes for 50 prescriptions by the government ensuring crore Indians, enabling the country to achieve fair return on investment by the private its avowed goal of Universal Health Coverge sector which must, in turn, follow complete (UHC) by 2030. Billed as the world's largest transparency to win popular support for the scheme of its kind, the PM-JAY, launched high-stake national initiative. on September 23, 2018 has a target of 10 Stakes are high because, only a healthy India crore families, extending them coverage of can fully exploit the demographic dividends. tertiary care hospitalisation . Within a year Being the second most populous country of its launch, the scheme which provides in the world with 1.3 billion people, India an annual coverage of Rs 5 lakh per family, has entered a demographic dividend phase as many as 46.5 lakh patients have already in 2018. It means a significant bulge (over availed of the benefit. 66 per cent) of our population is in the high It is not the health insurance coverage alone; consumption/working age of 15-64 years. equally important is another dimension of the This advantage is going to last till 2055, as scheme. Under Ayushman Bharat, 1.5 lakh this study has highlighted. But then, people health and wellness centres would be set up have to be healthy and educated so that in the country, making it one of the largest India can boast of its human resource which public primary healthcare networks in the is amongst the best in the world. Ayushman world. Bharat is a critical pillar here. ASSOCHAM along with KPMG undertook The ASSOCHAM-KPMG study, has delved an exhaustive study into the entire gamut into experiences and challenges ahead, of the scheme which was bound to yield making key recommendations to improve the different takeaways. As it is not a one-off outcome of the scheme which is amongst event, the scheme has to keep evolving, several flagship and important projects of dealing with complexities of implementation Hon'ble Prime Minister Shri Narendra Modi. on a mammoth scale as also throwing Along with Swachch Bharat, the Ayushman some pleasant results and generating vast Bharat can immensely contribute to making amount of goodwill amongst the vulnerable India a Swastha Bharat. families. India's healthcare sector largely depends on the private sector with gaps in public health infrastructure, resulting from less than 2 per cent of the GDP as public spending on healthcare. This makes it imperative for involvement of the private Deepak Sood sector in a scheme, as large and ambitious Secretary General as Ayushman Bharat. As the ASSOCHAM- ASSOCHAM d| © | 2019 KPMG, an Indian Registered Partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. Ayushman Bharat - A big leap towards Universal Health Coverage in India Foreword by KPMG in India The health status of a nation is not only reflective players. Partnership with private sectors can of its citizen’s well-being but also impacts its be leveraged in all key areas such as ensuring economic advancement. A healthy population patient engagement, provisioning of standardized is more productive and effectively contributes care, grading performance of hospitals, mitigating towards the overall progress of the country. This fraudulent activities by leveraging innovative makes healthcare coverage for each citizen vital. digital solutions, organizing referral pathways to The Indian Healthcare system is currently at a make basic healthcare services available in every very critical juncture, where it not only needs to household, and developing future care models overcome key healthcare issues, but also needs that can expand via access through technology, to progress towards path of Universal Health standardisation, skills mix and economies of scale. Coverage (UHC). The current healthcare system Going by the proverb, well begun is half done, of the country is burdened due to the limited it’s imperative that both the government and access to healthcare, insufficient availability of private players foster dialogue with each other by manpower, sub-optimal quality of health services building a collaborative forum, which can be used and high out-of-pocket (OOP) expenditure. In India, to discuss learnings from the past experiences every year, nearly 50 million people are pushed for effective execution; developing collaboration below the poverty line owing to healthcare charters; building flexibility to sustain the expenditure. A mere coverage of services is not partnership and setting up central agencies for enough to combat such a burden. Therefore, the evaluating PPP models as well as monitoring the current health system requires a mechanism impact. for providing holistic quality care to patients that can fill major healthcare gaps, provide extensive The purpose of this whitepaper is to find ways to healthcare coverage and improve health access leverage partnerships between the government for patients.1,2 and private sector as both are important stakeholders contributing towards rapid and With the release of National Health Policy 2017, effective implementation of the scheme. The the government laid the foundation of UHC in report also provides insights into challenges the country and the launch of Ayushman Bharat being faced during implementation of the scheme (AB) is a big leap towards the vision of ‘health and suggests additional interventions that can for all’. The design of Ayushman Bharat provides be incorporated to accelerate India’s journey a comprehensive coverage in all the verticals

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