Representative image of a hospital
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Bengaluru: The Yeshasvini Health Insurance Scheme for cooperative society members will now cover a total of 2,191 surgical procedures, with an estimated increase of Rs 70 crore in total expenditure.
On Tuesday, a rate revision committee led by Kudligi MLA Dr Srinivas N T submitted its report to Chief Minister Siddaramaiah, which observed these increased costs after including more procedures under the scheme and increasing their rates.
This committee, comprising eight doctors and 11 medical professionals from different departments, was constituted to revise procedure rates after the scheme, which was discontinued in 2017, was reintroduced by the BJP government in 2022.
However, since the procedure rates were the same as what were set in 2017-18, much lower than the market rate, many hospitals were hesitant to get empanelled.
After 13 meetings, the committee has increased the number of included procedures to 2,191 from 2,128, after six outdated surgical procedures were excluded and 69 procedures, including Interventional Radiology, Cardio Thoracic and Vascular Surgery (CTVS), and cancer treatment, were added.
In the 2024-25 financial year, 68,159 beneficiaries had availed treatments worth Rs 117.79 crore, with the average cost of Rs 17,000 per treatment. An estimated 75,000 beneficiaries are likely to avail treatments worth Rs 127.50 crore this year.
However, following the suggested rate revision, an additional increase of Rs 70 crore is likely in total expenditure.
"For some procedures, we have maintained the costs set earlier, while we have suggested an increase of about 15 per cent to 20 per cent in costs for some procedures. In rare, life-saving procedures, the costs have gone up by 80 per cent to 100 per cen as well," Dr N T Srinivas told DH.
The committee has suggested that the government can offer a grant of Rs 40 crore while the rest can be covered by cooperative society members' enrolment fees.
Srinivas hopes this rate revision will encourage more hospitals to apply for empanelment. As of this year, only 786 private and government hospitals are empanelled under the scheme.
"We are hopeful that the Finance Department will approve our plan soon. We have also proposed a plan to enroll more farmers and manage the scheme from the enrolment fees entirely in the future, to reduce government burden," he added.