IGUHC is continuing its support in one the key areas of healthcare quality and health benefit packages.
Quality of care is a key component of in providing healthcare, and the route to equity and dignity for patients. In order to achieve universal health coverage, it is essential to deliver health services that meet appropriate quality criteria. IGUHC through its support to NHA in implementation of PM-JAY has ensured that quality is not only assessed at the time of hospital empanelment but also at the time of service delivery. In order to cater to the increased demands under PM-JAY and also to ensure the quality care to the beneficiaries, it is imperative to maintain and grow a network of hospitals that also conform to the quality standards and criteria. This leads to the need of empanelment of hospitals on a pre-emptive basis so that beneficiaries are certain of their rights being honoured in the most convenient dignified manner. IGUHC has assisted ICMR in drafting standard treatment guidelines which are currently being used by NHA for implementation of PM-JAY.
Health Benefit Packages (HBP)
In any social health insurance scheme, it is critical to develop a balanced bundled health services for each condition (i.e package) taking into consideration every single component of the treatment. HBPs are not only detailed bundled health services of ailment but also units of payments to empanelled health care providers. IGUHC has successfully collaborated with NHA to develop a list of comprehensive HBPs, which will be covered for treatment under PM-JAY. Lately, IGUHC has supported NHA in bringing out its latest iteration of HBP 2.0, incorporating experience and feedback of scheme implementation of almost a year.