An autonomous research institute under the Ministry of Finance


Private Hospitals in Health Insurance Network in India: A Reflection for Implementation of Ayushman Bharat

Publication date

Feb, 2019


NIPFP Working Paper No. 254


Mita Choudhury and Pritam Datta


Private hospitals are expected to play a key role in the implementation of government sponsored health insurance schemes (GSHIS) in India. This paper examines the availability and spread of private hospitals in the country to provide insights on the potential access to insured health services in GSHIS schemes. It uses three sets of information to analyse the issue: private hospitals empanelled by insurance companies, the 6th Economic Census, and private hospitals empanelled in GSHIS schemes in four States. The analysis suggests that, in low-income States of the country, empanelment of private hospitals by insurance companies is low and concentrated in a few pockets. This pattern closely corresponds to the pattern of availability of private hospitals indicated in the 6th Economic Census. In Andhra Pradesh, Telangana, Tamil Nadu and Karnataka, the four States which have some of the largest GSHIS schemes in the country, there is a strong correspondence between private hospitals empanelled by insurance companies and private hospitals empanelled in GSHIS schemes. In these States, the extent of empanelment of private hospitals in GSHIS schemes is also substantially smaller than the empanelment of private hospitals by insurance companies. This may indicate differences in entry conditions or low willingness of private hospitals to participate in GSHIS schemes.
Key Words: Private health providers, Private hospitals, Ayushman Bharat, Pradhan Mantri Jan Arogya Yojana, Access to health care, India 
JEL Classification Codes: I11, I14
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