The Association of Hospitals of Eastern India (AHEI) is preparing to hold an internal meeting to formulate a proposal for the gradual integration of the Swasthya Sathi scheme with the central Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). Rupak Barua, president of AHEI and CEO of Woodlands Hospital, emphasized that a seamless merger of the two schemes would be ideal. He noted that a partial integration has already been implemented in Odisha, and the association aims to propose a strategy that ensures the majority of West Bengal's population benefits from a unified scheme. "There will be just one scheme, so we need to make it available to as many as possible. We will present our proposal to the state government," Barua stated.
Current Status of Empanelment and Patient Care
Several hospitals that were not previously part of the Ayushman Bharat panel are now in the process of getting empanelled. Meanwhile, patients continue to be admitted under Swasthya Sathi, and insurance claims are being honored. Rupali Basu, regional business head for East and Andhra Pradesh at HCG Cancer Hospitals, highlighted that Ayushman Bharat currently covers 30% of the population based on eligibility criteria, while Swasthya Sathi is a universal scheme for all residents of West Bengal. HCG Cancer Hospitals is in the process of joining the Ayushman Bharat panel for its New Town unit.
Challenges in Transition
A representative from a hospital on EM Bypass mentioned that an internal meeting will be held to discuss how to approach the new dispensation and ensure a smooth transition. The representative noted that transferring to Ayushman Bharat or merging the schemes could take time, as the schemes are different and no local resident currently possesses an Ayushman Bharat card. The hospital has been on the Ayushman Bharat panel for several years and admits patients under the scheme from neighboring states. The representative expressed a preference for a combined scheme that integrates both programs.
Government's Stance
Prashant Sharma, Managing Director of Charnock Hospital and President of the Indian Chamber of Commerce healthcare committee, revealed that the state government has decided to continue both schemes concurrently. Over a short period, they are expected to be merged or switched over to Ayushman Bharat. "That is the indication that we have received," Sharma said, suggesting that the transition is on the horizon.
The proposed integration aims to streamline healthcare benefits for West Bengal residents, reducing confusion and ensuring broader coverage. The AHEI's proposal will be crucial in shaping how the merger unfolds, balancing the strengths of both schemes to maximize accessibility and efficiency.
