Ayushman Bharat-KASP merger augurs well for health care

The expert committee appointed by the government for working out the costing modalities of implementing Karunya Arogya Suraksha Paddhati (KASP), Kerala’s new health financing scheme, in alignment with Ayushman Bharat-Prime Minister’s Jan Arogya Yojana (AB-PMJAY), has reported that that the merger can provide a better healthcare package and improve service provision without the State incurring a significant additional financial commitment.

If AB-PMJAY benefit package provided 1,354 health packages in 23 specialities, the list of packages under the merged KASP-AB scheme is 1,828. The expert committee, headed by D. Narayana, Director, Gulati Institute of Finance and Taxation, which submitted the report last month, estimated that the premium amount for this comprehensive package would have to be between ₹2,000-2,400.

Financial aid

KASP, in alignment with AB-PMJAY, will give financial protection to around 40 lakh households in the State and cover all major secondary and tertiary medical care services, including the treatment of cancer or cardiac diseases, in all empanelled public or private hospitals. It was in June last year that the government announced the consolidation of all health financing schemes into a pre-payment programme, KASP.

With the Centre announcing AB-PMJAY, offering an enhanced cover of ₹5 lakh/family, the State decided to implement KASP in alignment with it.

However, as AB-PMJAY would cover only 20.54 lakh families (BPL list under Census 2011), the State had been concerned about the additional funds it would have to find to extend this coverage to the additional 19.4 lakh families it was already covering under RSBY/CHIS. “The rates for all 1,828 procedures under KASP were compared across schemes to arrive at a standard estimate for each procedure. The committee has recommended that these rates be revised periodically as market costs escalate. This is the first time that any State has done such an exhaustive costing analysis of AB-PMJAY and State health insurance schemes to standardise insurance benefit packages,” a committee member told The Hindu.

Budgetary allocation

The State’s current budgetary allocation for RSBY/CHIS, with a claim package of ₹2 lakh and a premium of ₹1,100, plus other insurance schemes, is ₹792.91 crore. However, the actual outgo for the government is estimated at ₹270 crore as nearly 50% of the allocation for the schemes flows back to the public health institutions as claims.

For the merged new scheme, if the premium were to be fixed at ₹2,100, the State’s budgetary allocation would have to be ₹717.74 crore (excluding the Central allocation of ₹142.43 crore). In this case, the estimated net outgo from the State government would only be ₹192.17 crore.

The committee thus estimated that whichever model of financing healthcare was chosen by the State, the net outgo from the government would be less than ₹200 crore annually.

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Printable version | Nov 28, 2021 6:34:38 PM |

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