The All Odisha Private Medical Establishment Forum (AOPMEF) has raised strong concerns about the challenges faced by private healthcare providers under the Ayushman Bharat PMJAY and Gopal Bandhu Jan Arogya Yojana (GJAY) schemes in the state.
In a detailed appeal submitted to State Health Minister Mukesh Mahaling, the forum pointed out a range of pressing issues—from outdated package pricing and technical glitches to operational hurdles—that are making it increasingly difficult for private hospitals to sustain services.
One of their key demands is a minimum 30% increase in package rates, citing that the current rates, carried over from the earlier BSKY scheme, do not reflect rising medical costs or inflation. “The present rates are not financially viable and will ultimately affect the quality of patient care,” the forum noted.
High-cost procedures like cardiotocography (CTG) used during lower segment cesarean sections (LSCS) are reportedly being covered under low-value packages, such as ₹15,000, making it hard for hospitals to deliver quality care under such constraints.
AOPMEF Secretary Dr. Indramani Jena also pushed for a revision in implant package rates and the reinstatement of editable pricing options. He quoted examples like pacemakers being capped at ₹75,000 and spine implants at just ₹10,000 rates that he described as unsustainable for critical surgeries. He also called for the inclusion of essential diagnostic tests like CT scans, MRIs, and pulmonary function tests that are currently missing from the scheme.
On the operational side, hospitals are struggling with impractical processes like 24×7 Aadhaar-based OTP authentication that must be performed by medical superintendents, which they say is not feasible in real-time hospital settings. AOPMEF has suggested allowing medical coordinators to take over such tasks to improve workflow efficiency.
Hospitals also flagged burdensome discharge procedures, such as the mandatory submission of medical slips and patient photographs, which are difficult to manage and time-consuming. Adding to their frustration are frequent software issues—slow systems during peak hours, disappearing uploaded documents, and the lack of features like real-time card verification and balance checks.
AOPMEF President Dr. Subrat Jena emphasized the need for better IT support and a more decentralized approach to management. “Healthcare is a state subject. Local officials should have the authority to resolve operational and payment-related issues instead of relying on central-level decisions,” he stated.
The forum has urged the government to act swiftly and consider their recommendations to ensure the sustainability of private healthcare services under these critical health schemes.
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