After the announcement of the Ayushman Bharat and National Health Protection Scheme (NHPS), the Ministry of Health & Family Welfare has started the process of State consultations. On February 09, 2018 a Video Conferencing was held with all the State to share initial details of the proposed NHPS. All States had shown keenness to join.
To further have detailed discussions with the States and other relevant stakeholders, a national consultation on NHPS was organized by the Ministry of Health & Family Welfare on 15-16 February 2018 at New Delhi. The objective of this consultation was to discuss with the States further details about the scheme, assess their preparedness, to learn from the States which had good experience in implementing their own health insurance/ assurance schemes. Background notes and concept paper of the scheme was shared in advance with all the States.
Almost all States and Union Territories (31) participated in the two-day deliberations along with representatives from Ministry of Health and Family Welfare, Ministry of Finance, NITI Aayog and other stakeholders.Most States were represented at the level of Additional Chief Secretary/ Principal Secretary/ Secretary Health. The two-day consultations were attended by more than 200 participants.
In order to engage with States so as to finalise the contours of the scheme, six Working Groups were formed. These are:
Working group on processes: The working group was set up to recommend the details of various processes related to NHPS which will be incorporated in the broad operational guidelines proposed to be issued for implementing NHPS.
Working group on Information Technology: The working group was set up to recommend on the on Information Technology System/ Platform that will be used for effective implementation of NHPS.
Working group on fraud detection and grievances: The working was set up to recommend strategies to prevent and control potential frauds and abuse that may happen under the scheme. The group will also recommend a mechanism for complaint and grievance redressal at each level under the scheme.
Working group on Awareness generation: The working group was set up to recommend on the IEC and awareness generation activities that will need to be carried out for implementation of NHPS.
Working group on Institutional arrangement: The working group will need to recommend on the Institutional Arrangement that will need to be carried out for implementation of NHPS.
Working group on Continuum of Care: The working group was set up to define the scope and range of the continuum of care approach such that when NHPS evolves over the years, the direction of this growth is pre-defined.
The groups had detailed deliberations based on the experiences of Rashtra swasthya Bima Yojana (RSBY) implementation, implementation of the States’ own schemes and global experiences. Best practices for each of the process related to beneficiary identification, hospital empanelment, hospitalization services, grievance redressal mechanisms, IEC activities etc., were identified from each State and recommendations were presented by each working group to the Ministry. States also shared the current challenges being faced and potential solutions were shared with them.
On the second day of national consultations, five groups of States were formed based on the implementation status of health insurance schemes:States with only RSBY, States with RSBY and their own schemes, States with only their own schemes in Insurance mode, States with only their own schemes in Trust mode and States with no health insurance/ assurance schemes.
Each of these five categories of States identified issues and likely solutions. The bilateral meeting was held by Secretary Health and Member Health NITI on the preparedness of the States to integrate/ operationalize the scheme.