ACCESS Health strengthens compliance to standard treatment guidelines amongst private medical colleges in Uttar Pradesh, India

ACCESS Health in the Indian state of Uttar Pradesh has initiated a series of virtual trainings to strengthen compliance to standard treatment guidelines among private medical colleges, under the social health insurance scheme, Pradhan Mantri Jan Arogya Yojna (PM-JAY). In view of need for clear clinical guidance and monitoring mechanisms to improve quality of care, reduce costs, and curtail malpractice, the National Health Authority (NHA) has endorsed standard treatment guidelines (STGs) for PM-JAY health benefits packages.

The objective of these guidelines is to improve the quality of patient care by providing tools to treating doctors and aid insurance functionaries in identification of fraud and abuse during pre-authorization & claims management. There are 16 virtual sessions with a participation of around 25 private medical colleges to strengthen usage of evidence-based protocols. The trainings will cover a gamut of topics including general medicine, general surgery, medical oncology, ophthalmology, urology, cardiology, obstetrics and gynaecology, radiation oncology, and cardio-thoracic vascular surgery.

The training initiative is part of the Ayushman Samvaad of State Agency for Comprehensive Health and Integrated Services (SACHIS) to encourage dialogue and knowledge transfer for universal health coverage under PM-JAY in the state. Thus far, six training sessions have been completed with private medical colleges. In the interactive sessions, queries regarding the topics along with claim processing are addressed among others. The training initiative will conclude in August 2024.