Private Hospitals in Health Insurance Network in India: A Reflection for Implementation of Ayushman Bharat

Mita Choudhury () and Pritam Datta ()
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Mita Choudhury: National Institute of Public Finance and Policy
Pritam Datta: National Institute of Public Finance and Policy

Working Papers from National Institute of Public Finance and Policy

Abstract: Private hospitals are expected to play a key role in the implementation of govern-ment sponsored health insurance schemes (GSHIS) in India. This paper examines the availability and spread of private hospitals in the country to provide insights on the po-tential access to insured health services in GSHIS schemes. It uses three sets of infor-mation to analyse the issue: private hospitals empanelled by insurance companies, the 6th Economic Census, and private hospitals empanelled in GSHIS schemes in four States. The analysis suggests that, in low-income States of the country, empanelment of private hos-pitals by insurance companies is low and concentrated in a few pockets. This pattern closely corresponds to the pattern of availability of private hospitals indicated in the 6th Economic Census. In Andhra Pradesh, Telangana, Tamil Nadu and Karnataka, the four States which have some of the largest GSHIS schemes in the country, there is a strong correspondence between private hospitals empanelled by insurance companies and pri-vate hospitals empanelled in GSHIS schemes. In these States, the extent of empanelment of private hospitals in GSHIS schemes is also substantially smaller than the empanelment of private hospitals by insurance companies. This may indicate differences in entry con-ditions or low willingness of private hospitals to participate in GSHIS schemes.

Keywords: Private health providers; Private hospitals, Ayushman Bharat; Pradhan Man-tri Jan Arogya Yojana; Access to health care; India (search for similar items in EconPapers)
JEL-codes: I11 I14 (search for similar items in EconPapers)
Pages: 22
Date: 2019-02
New Economics Papers: this item is included in nep-ias
Note: Working Paper 254, 2019
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (4)

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