ACCESS Health India Working Towards Building a Health Insurance Ecosystem in Uttar Pradesh

The Indian state of Uttar Pradesh with a population of over 200 million people launched Ayushman Bharat AB-PM-JAY in September 2018, which is implemented by State Agency for Comprehensive Health and Integrated Services (SACHIS). The program is the largest health insurance scheme in the world which aims at providing a health cover of Five Hundred Thousand Indian Rupees per family per year for secondary and tertiary care hospitalization to the bottom 40 percent of the Indian population. The state of Uttar Pradesh provides coverage to 37 percent of its 200 million population with a commitment to move towards Universal Health Coverage.

The session Partners in Health aimed to bring together multisectoral allies towards building an AB-PM-JAY ecosystem in the state. The session was Chaired by Secretary to the Chief Minister of Uttar Pradesh and the expert panel comprised of policy makers and practitioners from Department of Health and Family Welfare, Department of Rural Development, Department of Panchayati Raj and Corporate Social Responsibility Partner HCL Foundation. The group deliberated on the challenges and the opportunities for collaborations.

The panel discussion highlighted the demand and supply side issues in implementation of AB-PM-JAY. Some of these included limited awareness among eligible beneficiaries and lower enrollment rates, limited participation of the empaneled public sector providers due to inadequate understanding of the scheme and infrastructural and human resources gaps. The crucial linkages between Health and Wellness Center to deliver primary health care and AB-PM-JAY still need to be fully developed to ensure the continuum of care. At Interdepartmental convergence level coordination remains difficult due to multiple beneficiary databases, which do not interact with each other and variety of other departmental issues. The catalyst role of corporate partners in fast tracking health programs was emphasized. 

The opportunities for collaboration to continue the momentum were outlined. Some of the significant ones included setting up of Partners Forum a joint multi partner coordination forum; focus on building capacities of demand and supply side stakeholders, understanding the actual supply available for provider expansion and management; grassroot mobilization of communities through positive stories from the happy and satisfied AB-PM-JAY beneficiaries and leveraging the network and the power of local self-governance bodies. The session also formalized a partnership between HCL Foundation, SACHIS and ACCESS Health to leverage the network of integrated community development initiatives to increase demand and supply of PM-JAY in the state.