Over 600 private hospitals in Haryana are set to stop treating patients under the Ayushman Bharat scheme starting February 3, 2025, due to ongoing financial difficulties exacerbated by delayed reimbursements from the state government. The situation has escalated to a point where private healthcare providers are no longer able to sustain operations under the existing terms, as they continue to wait for overdue payments amounting to a staggering Rs 400 crore.
Ayushman Bharat, a flagship health insurance initiative launched by the Narendra Modi government in 2018, has been integral in providing free healthcare services to millions of Indians, including residents of Haryana. The scheme covers hospital treatments up to Rs 5 lakh per family annually, ensuring access to a wide range of medical services, from routine checkups to life-saving surgeries. The program currently includes around 1,300 hospitals in Haryana, of which 600 are private entities.
However, the delayed reimbursement process has created immense financial strain for many of these hospitals. The Indian Medical Association (IMA) of Haryana has now raised the alarm, as the state’s private healthcare institutions struggle with mounting bills and dwindling resources. According to Mahavir Jain, the president of IMA Haryana, private hospitals have been waiting for reimbursements for several months, with no significant resolution in sight.
Delays in Payment and Impact on Healthcare Providers
The payment delays have become a critical issue for hospitals that have been providing healthcare services to Ayushman Bharat beneficiaries. Hospitals typically submit reimbursement requests for the treatment of Ayushman Bharat patients through an online portal. The state government then processes and approves these claims before reimbursing the hospitals. However, the process has been sluggish, and many hospitals have reported receiving only a small fraction—10 to 15 percent—of the reimbursements they are owed.
A doctor from one of the empanelled hospitals in Gurugram voiced their concern over the ongoing difficulties, stating that the slow reimbursement process was putting their hospital’s operations at risk. “The reimbursement process is slow, and new bills keep adding up. Immediate release of payments is essential for us to continue functioning,” the doctor explained. Without timely reimbursements, hospitals are increasingly finding it difficult to cover operational costs, which include staff salaries, medical supplies, and maintenance.
IMA’s Stand and Urgency of the Situation
The IMA Haryana has called for urgent action to resolve the payment delays. Mahavir Jain underscored the gravity of the situation, emphasizing that hospitals simply cannot operate without receiving the necessary funds to cover their expenses. “Around Rs 400 crore is still pending, and these bills have already been discounted by the hospitals. How can they continue if they do not receive basic payments?” Jain asked. The association has also expressed its frustration with the slow pace of reimbursement processing, with hospitals having received only a small portion of the funds due to them.
Despite raising the issue with Chief Minister Nayab Singh Saini, who had directed the prompt release of funds, the hospitals have seen little improvement. Dhirendar K Soni, the secretary of IMA Haryana, added, “Even after 15 days, no significant amount has been received. The funds released have been subject to substantial, unjustified deductions.”
Suspension of Services and Impact on Patients
As a result of these ongoing financial issues, over 600 private hospitals in Haryana have announced that they will cease providing services under the Ayushman Bharat scheme starting February 3. The hospitals affected by this decision include some of the well-known facilities in Gurugram, such as Park Hospital, Centre for Sight, Pushpanjali Hospital, and Kamla Hospital. These hospitals have been serving a significant number of Ayushman Bharat patients, including those requiring eye surgeries, medical tests, and emergency treatments.
Jyoti Yadav from Kamla Hospital confirmed the hospital’s decision to support the IMA’s stance, stating, “We will suspend services from February 3, as we have no other option.” This suspension will affect the treatment of approximately one to two new Ayushman Bharat patients per day, including essential medical procedures like eye surgeries. The ongoing payment delays have left many hospitals with no choice but to prioritize their financial sustainability over continued participation in the scheme.
The suspension of services will inevitably lead to a significant gap in healthcare availability for those dependent on Ayushman Bharat for their medical needs. As one of the largest health insurance schemes in India, Ayushman Bharat has been crucial in providing affordable healthcare to millions, particularly for families from economically disadvantaged backgrounds. The halting of services in such a large number of private hospitals will not only cause inconvenience to patients but also place additional pressure on the public healthcare system, which is already burdened with its own set of challenges.
Government’s Response and Challenges
In response to the announcement of the service suspension, Ankita Adhikari, the joint CEO of Ayushman Bharat in Haryana, stated that her office had not been formally informed about the cessation of services. “We have already initiated the fund release process, and we are confident that the issue will be resolved within a week. We hope such drastic measures will not be necessary,” she said, expressing optimism that the funds would be released soon to prevent the situation from escalating further.
Despite the assurance from Ayushman Bharat’s officials, the IMA Haryana remains skeptical, given the ongoing delays and the lack of clarity regarding the timely release of the pending payments. The situation has now reached a breaking point, with the IMA warning that hospitals can no longer continue treating Ayushman Bharat patients without receiving the necessary reimbursements. The issue of delayed payments has been a longstanding problem in several states across India, with many private hospitals struggling to stay afloat while waiting for reimbursement under the scheme.
Ayushman Bharat’s Impact and Future Challenges
Ayushman Bharat has been hailed as a revolutionary step towards achieving universal health coverage in India. The scheme provides free healthcare to over 100 million families, which translates to more than 500 million individuals. In Haryana alone, approximately 10.2 million people are enrolled in the scheme. The program covers a wide range of medical services, including hospitalization, surgeries, diagnostics, and medicines, ensuring that the poorest and most vulnerable populations have access to quality healthcare.
However, the delayed reimbursement process threatens the sustainability of the scheme, especially for private hospitals that play a crucial role in delivering healthcare services. Many private hospitals in India, including those in Haryana, have partnered with the government under Ayushman Bharat to expand access to healthcare services. Yet, without the timely release of funds, these hospitals are increasingly unable to continue providing services under the scheme, thereby undermining the program’s objectives.
The situation in Haryana also highlights a larger systemic issue regarding the funding and operational challenges of government health insurance schemes. While Ayushman Bharat has had a positive impact in expanding healthcare access, it is clear that there are significant gaps in the reimbursement and payment processing systems that need to be addressed for the scheme to achieve its full potential.
Urgency for Resolution
As more private hospitals in Haryana announce their intention to suspend services under Ayushman Bharat, it is imperative that the government takes immediate action to resolve the financial crisis faced by these healthcare providers. The Rs 400 crore in pending reimbursements must be released promptly to ensure the continued functioning of hospitals and the health of millions of beneficiaries relying on the scheme for essential healthcare.
The delays in payments have already strained the relationship between private hospitals and the government, and if left unresolved, this issue could undermine the trust and cooperation needed to sustain the success of Ayushman Bharat. In this critical moment, swift and decisive action is necessary to prevent further disruptions in healthcare delivery and to uphold the integrity of one of India’s most important public health initiatives.
