India: Strengthening Universal Health Coverage in India: Supporting the Implementation of Pradhan Mantri Jan Arogya Yojana

Health / Health sector development and reform

Recommendations for digital solutions to improve the operational efficiency of PM-JAY implementation formulated

Innovative models of financing and service delivery developed

Framework and strategies developed to strengthen states' capacity for implementation

Framework and strategies developed to strengthen private sector response to COVID-19 pandemic

1. Output 1: The TA has supported digital solutions for claims management and fraud detection for the health insurance schemes of ministries participating in the AB-PMJAY. Ongoing and/or remaining activities include drafting of legal guidelines for dealing with fraudulent practices and related issues, and assessment of information-technology-related gaps in medical audits.

2. Output 2: Innovative models of financing and service delivery supported. The TA supported the service delivery innovations agenda through the NHA's Market Access Programme (MAP) which identified 14 healthcare innovations and further supported them with validation, advisory and market support. Ongoing and/or remaining activities include (i) drafting of an _innovation handbook_ documenting the journey of innovation unit, lessons learnt, and identifying the best practices for operationalizing such units in other government departments; and (ii) organizing a multi-stakeholder national workshop with focus on mainstreaming of health care and financing innovations.

3. Output 3: Framework and strategies developed to strengthen states' capacity for implementation. The TA supports pedagogy, content development, and technical assessment of the training programs of NHA. The framework for information, education, and communication (IEC) strategy for last-mile beneficiary awareness has been developed by the TA consultants, and monitoring support in roll-out of various IEC initiatives has been provided. Ongoing and/or remaining activities include (i) finalization of framework for internal knowledge management, and (ii) conducting workshops to present the proposed capacity development framework to states.

4. Output 4: Framework and strategies developed to strengthen private sector response to COVID-19 pandemic. Development of a policy document on ensuring free COVID-19 testing and treatment for AB-PMJAY beneficiaries was supported by TA consultants; and to improve the availability of COVID-19 services, the TA supported development and implementation of a strategy to expedite the private sector hospital empanelment under AB-PMJAY. Ongoing and/or remaining activities include conducting stakeholder consultations for developing and finalizing a strategy to augment testing and treatment in underserved locations.