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Hospital Empanelment Under Ayushman Bharat drops over low rates

Sanchari ChattopadhyayWritten by Sanchari Chattopadhyay Published On 2025-06-05T10:15:13+05:30  |  Updated On 5 Jun 2025 10:48 AM IST
Ayushman Bharat Yojana

Ayushman Bharat Yojana

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New Delhi: The rate of hospital empanelment under the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) has seen a sharp decline in 2025, sparking concerns about the scheme's growing disconnect with private healthcare providers.

Also Read:Major Hospitals to Join Ayushman Bharat in 25 Days: Delhi Health Minister

Data from the National Health Authority (NHA) reveals that the average monthly empanelment has fallen from 316 hospitals in 2024 to just 111 per month so far in 2025. Between January and April this year, only 443 hospitals joined the AB-PMJAY network nationwide, with a noticeable downward trend: 161 in January, 187 in February, plummeting to 40 in March, and 55 in April, according to the Times of India. The situation worsened in May, with just 20 new empanelments recorded.

Several healthcare associations have attributed the steep fall in participation to persistent issues such as low treatment package rates and significant payment delays, which have discouraged large private and corporate hospitals from enrolling in the scheme. These challenges continue to hinder the scheme's reach and effectiveness, particularly in urban areas where private facilities dominate.

Despite these concerns, a senior official from the NHA, which administers the AB-PMJAY, clarified that empanelment is ongoing. The official added that some of the new entries may not yet be reflected in the data due to a transition to a new system. Ayushman Bharat-PMJAY is India’s flagship health insurance scheme and is operational in all states and Union Territories except West Bengal. It provides free treatment up to Rs. 5 lakh per family annually, covering nearly 2,000 medical procedures, including those related to cancer care, emergency services, orthopaedics, and kidney diseases.

The recent dip in empanelment has raised concerns about the scheme’s future scalability and its ability to meet healthcare demands, particularly for economically weaker sections that rely heavily on this government-supported health initiative.

The CEO of a top hospital chain in Delhi told TOI that the input cost for several procedures under the scheme was way higher than the package rates. "We may join the scheme if the package rates are increased," he said. IMA members are also concerned about the number of packages and stated that the rates should be increased to cope up with the CGHS level.

Also Read:Gujarat tops the list as 609 private hospitals exit Ayushman Bharat scheme

“The reasons for hospitals voluntarily opting out include empanelment only for Covid period, hospitals were closed or non-functional, changes in hospital entity, hospital relocated, ongoing reconstruction or renovation, unavailability of specialist doctors, voluntary withdrawal from scheme, package rates, opting out due to certain treatment packages reserved for public hospitals only (Chhattisgarh and Gujarat), and no referral from public hospitals (Karnataka),” he added.

Gujarat has recorded the highest number of private hospitals withdrawing from the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), with 233 private hospitals opting out since the scheme's launch in 2018.
private hospitalNational Health AuthorityNHAprivate hospitalsAyushman Bharat Pradhan Mantri Jan Arogya YojnaAB PMJAY cards
Source : with inputs
Sanchari Chattopadhyay
Sanchari Chattopadhyay

    Sanchari Chattopadhyay has pursued her M.A in English and Culture Studies from the University of Burdwan, West Bengal. She likes observing cultural specificities and exploring new places.

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