National Health Authority (NHA) is introducing a new system to measure and grade hospital performance under the flagship scheme Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY). 

The new initiative will introduce the concept of ‘value-based care’, where payment will be outcome-based and providers will be rewarded according to the quality of the treatment delivered. Under the new model, the providers will be rewarded for helping the patients improve their health, which consequently will reduce the effects of the disease in the population in the long term. 

The step promises a significant increase in overall health gains and is expected to be a win-win for all concerned stakeholders from patients to healthcare providers, payers and suppliers. While the patients will get better health outcomes and higher satisfaction out of the services they receive, providers stand to get better care efficiencies. Similarly, payers will be able to maximise the health benefits generated out of the spending incurred. 

Under value-based care, the performance of AB PM-JAY empanelled hospitals will be measured based on five performance indicators such as: Beneficiary Satisfaction; Hospital Readmission Rate; The extent of Out-of-Pocket Expenditure; Confirmed Grievances and Improvement in patient’s Health-Related Quality of Life.