Bengaluru Launches Direct Access to Ayushman Bharat at Private Hospitals
In a significant move to address the escalating health burden in Bengaluru and bridge critical gaps in public healthcare infrastructure, the Karnataka government has forged partnerships with four private medical colleges and hospitals. This initiative enables patients to receive treatment under the Ayushman Bharat–Arogya Karnataka (AB-ArK) scheme at government-prescribed rates, eliminating the need for referrals from public facilities.
Direct Walk-In Access for Patients
Under this new arrangement, beneficiaries can directly approach these private hospitals and avail themselves of medical procedures free of cost, mirroring the experience at government healthcare centers. The pilot program, sanctioned for a duration of one year, includes St John's Hospital, Ramaiah Memorial Hospital, Kempegowda Institute of Medical Sciences (KIMS), and Dr BR Ambedkar Medical College and Hospital.
The decision received approval during a recent cabinet meeting presided over by Chief Minister Siddaramaiah, strategically timed ahead of the upcoming city civic polls. Harsh Gupta, Principal Secretary of the Health Department, elaborated on the rationale behind selecting Bengaluru for this pilot. "Bengaluru faces a pronounced shortage of healthcare facilities. According to Indian Public Health Standards norms, the city requires an additional 3,000 to 4,000 government hospital beds. While we are actively working to develop this infrastructure, citizens must continue to have access to medical care. Bengaluru possesses abundant private sector capacity that can be leveraged," Gupta explained.
Relaxation of Previous Restrictions
Previously, the AB-ArK scheme imposed two major limitations: 291 procedures were exclusively reserved for government hospitals, while another 1,200 procedures—including common surgeries like appendectomies and hernia repairs—could only be accessed at private hospitals with a referral from a government facility. Gupta clarified, "Both these restrictions have been relaxed for the four empanelled hospitals, as they possess the necessary infrastructure and capabilities, ensuring the care provided is comparable to that in public healthcare institutions."
Patients will not be charged for treatments, with the government committing to reimburse 75% of the prescribed AB-ArK rates to the hospitals. This financial model aims to facilitate seamless healthcare delivery while managing costs effectively.
Concerns Raised by Health Activists
Despite the government's positive outlook, health activists have expressed caution, warning that the initiative may not yield substantial benefits for the public due to inherent practices in private hospital systems. Dr. Sylvia Karpagam, a public health doctor and researcher, highlighted potential pitfalls. "Studies indicate that patients often incur out-of-pocket expenses in private hospitals despite government schemes. Outpatient department (OPD) care is not covered under this arrangement; only surgeries are reimbursed. There is also a risk that hospitals might cherry-pick easier cases or order unnecessary tests to maximize revenue," Karpagam stated.
This pilot program represents a critical step in integrating private healthcare resources with public health schemes, aiming to alleviate pressure on Bengaluru's overburdened public facilities. The outcomes of this one-year initiative will likely influence future healthcare policies and collaborations across Karnataka and potentially other regions facing similar challenges.
