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FICCI Task Forces

Costing of Healthcare Services

a)    Revision of AB-PMJAY reimbursement packages with National Health Authority (NHA)

The reimbursement rates currently provided by the government under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) are not remunerative or viable to most of the healthcare providers- whether large corporates or small and middle level hospitals. Many of the procedures are much below the actual input costs for the hospitals.  

Sustainability of private hospitals should be an important consideration for any such scheme given that there are many hidden costs that the private hospitals need to cater to- land, building, equipment, manpower, electricity, etc. which need to be factored in the costing of packages.

FICCI has been actively advocating with the government and at various forums for the revision of reimbursement rates for PMJAY as well as other health insurance schemes. A Study on ‘Demystifying Healthcare Costs: A Scientific Approach (2018-19) was conducted which presented the methodology of scientific study on costing of select medical procedures across private and public hospitals from around the country, employing Time Driven Activity Based Costing.

Recently, NHA had initiated package rationalization for AB PM-JAY. FICCI submitted suggestions on package rates along with industry concerns on the scheme. FICCI also collaborated with other associations and PWC to submit collated response on the NHA Paper on Pricing and Payment for AB-PMJAY.

b)    Revision of CGHS Rates in collaboration with other Healthcare Associations

In 2021, FICCI had joined the forces with other healthcare associations, after AHPI initiated a cross-federation Mission: CGHS Tariff Revision. The Institute of Cost Accountants of India (ICWAI) agreed to join this task and initiated a Study on Cost of Healthcare Services with the aim to develop Performance Costing System, find most competitive costs, and recommend uniform rates for all medical procedures performed by different category of Hospitals & Nursing Homes across India.