“Transforming Healthcare: The Evolution from HBP 1.0 to HBP 2.0 in AB PM-JAY”
It looks like you have a comprehensive overview of the transition from Health Benefit Package (HBP) 1.0 to HBP 2.0 within the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY). Here’s a concise summary of the key points covered:
To get the offers, advertisements and news of your establishments directly to the masses (more than 52 thousand people) through website, Facebook, WhatsApp, Instagram, YouTube, Twitter and Telegram contact- 🪀9778362400
Overview of HBP 1.0
- Package Rates and Payments: Hospitals receive bundled payments for surgical packages, which cover all associated treatment costs, including pre and post-hospitalization expenses. Medical packages are paid based on a daily rate, and day-care packages follow a similar structure to surgical packages.
- Scope: The packages encompass treatments across 24 specialties, including super-specialty areas like oncology and neurosurgery. Certain high-end procedures not included in HBP 1.0 required prior approval for rates up to INR 1,00,000.
Feedback and Issues Identified
- Inadequate Package Rates: Many stakeholders felt that the rates did not cover the costs of procedures.
- Duplication and Inconsistency: Packages had issues with duplication within and across specialties and inconsistent terminology.
- Overlapping Procedures: Some packages overlapped with existing National Health Programs.
- Unspecified Packages: A significant number of procedures were categorized as unspecified due to a lack of available treatments.
Transition to HBP 2.0
- Rationalization Process: Feedback led to the formation of 24 specialist committees, collaboration with Tata Memorial Hospital, and data collection from public hospitals to inform package pricing.
- Key Changes Approved:
- Price Adjustments: Increase in 270 packages, decrease in 57 packages, retention of 469 packages, and introduction of 237 new packages.
- Stratification and Discontinuation: Stratification of 43 packages and discontinuation of 554 packages, including Tubectomy and Vasectomy under the National Family Welfare Program.
Flexibility for States
- States with their own health schemes can set rates for all packages while adhering to a mandatory list of 1,391 packages from PM-JAY. States without their own scheme can adopt national packages with specific modifications.
Advantages of HBP 2.0
- Enhanced Coverage: The new structure allows for more disease conditions and procedures, with a reduced total package count.
- Reimbursement Changes: Certain packages can now be booked for 100% reimbursement, contrasting with previous limitations.
- Follow-up Packages: New follow-up packages ensure continuity of care for prolonged or multiple follow-up procedures.
- Fraud Prevention Features: New measures minimize fraud potential, including defined time intervals for package bookings and maximum permissible limits for implants.
- Improved IT Customization: Enhanced analytics and monitoring through a three-layered IT structure and standardized coding for package booking.
This transition aims to improve the efficiency, coverage, and fairness of the healthcare package system under the AB PM-JAY initiative, ensuring better health services for the population. If you need further information or specific details about any aspect, feel free to ask!
To get the offers, advertisements and news of your establishments directly to the masses (more than 52 thousand people) through website, Facebook, WhatsApp, Instagram, YouTube, Twitter and Telegram contact- 🪀9778362400