Private hospitals to seek hike in Yeshasvini scheme rates

With the new government swearing in, the Indian Medical Association (IMA) and Private Hospitals & Nursing Homes Association (PHANA) are planning to push for higher package rates under Yeshasvini health insurance scheme.

They say the government should set up a committee to assess actual procedure costs at private hospitals and recommend new rates.

The scheme offers health coverage for 1,650 treatments to members of cooperative societies, including farmers.

The scheme, which was stopped in 2018, was relaunched by the Bommai government last November. During the relaunch, the new scheme adopted same package rates as the public insurance scheme Ayushman Bharat-Arogya Karnataka (AB-ArK). However, since some of these rates were even lower than the 2018 Yeshasvini scheme rates, many private hospitals refused to accept patients under it.

The government then adopted the same package rates as the 2018 Yeshasvini scheme, after which more hospitals enrolled. As of now, 505 hospitals and 37.9 lakh cooperative society members are enrolled. Around 13,800 procedures have been done, says Venkataswamy, CEO of Yeshasvini Trust.

But low rates remain challenging, says IMA state secretary Dr Karunakara B P. “The cost of a C-section now is Rs 15,000, whereas private hospitals in Bengaluru charge Rs 60,000 to Rs 1 lakh for this.” Surgical procedures are affected as they can’t be done for low amounts, he says.

“With inflation, private hospitals have to increase rates by 5-10 per cent annually. But the Yeshasvini rates are the same as five years ago,” he said.

IMA and PHANA will approach the government once portfolios of ministers are decided, said IMA state president Dr Shivakumar B Lakkol, adding that low rates are more challenging for small hospitals.