Ayushman Bharat Pradhan Mantri Jan Arogya Yojana Capacity

Ayushman Bharat -Pradhan Mantri Jan Arogya Yojana Capacity Building State Health Agency - Assam

Assam>AB-PMJAY Overview *Simultaneously Assam is implementing State’s flagship scheme Atal Amrit Abhiyan

Why Assam is unique? • Wide spread geography : 78, 438 km 2 , 16 th largest state of India. • Total Population of 3, 16, 9, 272 & Number of Districts : 33 • Approximately 1. 35 crore members population covered under AB-PMJAY • Each Family given laminated physical AB-PMJAY card • Daily Allowances of cash benefit of Rs. 1000/- per day upto Rs. 10000/-per day is covered. Not provided in PMJAY but Assam Govt is providing • Transport cost inside Assam Rs. 300 to Rs. 3000 and for outside state is capped upto INR Rs. 30000/- per year Not provided in PMJAY but Assam Govt is providing

How does Assam approaches capacity building assessment ? • Monthly PMAM refresher training at district level and cluster level • Periodic empanelled hospital training with regards to updated • Adjudication guidelines, beneficiary identification and procedure selection • Department wise training of doctors at major empanelled hospital and medical colleges for identifying AB-PMJAY beneficiaries and treatment under AB-PMJAY • Periodic training of the hospital administrators assessment of ground problems • Provision of training material to all the stakeholders whenever required • Hosting of special training session as per hospital request

Stakeholders

Identified Capacity Gaps & challenges faced by stakeholders and its resolutions. Challenges identified and resolved by training and proactive Stakeholders measures Constant need of training, focus on development of soft skills. High PMAMS Attrition. Post training assessment by questionnaire. 1. Appointment of district coordinators and Cluster Heads to monitor and train PMAMs. 2. Appointment of hospital FOSS administrators and pharmacist by SHA in government hospitals. 3. Appointment of qualified doctors at each district level Bimonthly performance and implantation review. Corrective and ISA proactive measures implementation TAT given to ISA. For noncompliance penalties levied on ISA.

Identified Capacity Gaps & challenges faced by stakeholders, being resolved by training and awareness programmes by SHA. Conti. . Challenges identified and resolved by training and proactive Stakeholders measures EHCP’s Training at the time of empanelment. Issues faced regarding package private amount and package selection. Training at the time of empanelment. Issues faced regarding package EHCP’s Public amount and package selection. Conduction of department wise training. High number of PMAMs deployment as the number of beneficiary.

SHA’s Capacity Building Programme: Types of Trainings Conducted • Orientation and Monthly PMAM refresher training at each district level • Periodic empanelled hospital training with regards to updated adjudication guidelines, beneficiary identification. Procedure selection • Department wise training of doctors at major empanelled hospital and medical colleges for identifying AB-PMJAY beneficiaries and treatment under ABPMJAY • Periodic training of the hospital administrators assessment of ground problems • Trainings to ISAs to cascade awareness to primary health partners: ASHA, Joint Directors, Block Officer • Triggers implementation and action against the triggers • Anti-fraud trainings , conduction of medical, hospital , death and beneficiary audits • Routine PPD and CPD training with respect to new adjudication guidelines

Way forward • Analysis of Strengths and Weaknesses of the existing Capacity Building • Identification of people and skill set for augmenting existing capacities • Leveraging the internal Capacities of people within the institution through adequate training • Involvement of professionals from the government and privates healthcare sector to complement the existing capacities • Adopt strategic partnership or technology for pre and post training assessment • Intra department trainings • Increasing frequency of the trainings • Increase interactions with others state

Assam>Case Studies > Medical colleges PMAM’s given training for BIS Medical colleges PMAMs orientation and BIS training

Assam>Case Studies > Training of Asha’s/Self help groups given training for conversion of obstetrics and gynaecology beneficiaries.

State Level workshop State level workshops for all Empaneled Hospitals and PMAMs

IEC Materials Information materials for Beneficiaries

Impact of SHA training initiatives. • Increase number of beneficiary registration and preauthorisations • 900+ PMAMs so far trained, reduction in mistakes & patient BIS verification time • Increase in claim processing/disposal rate • Decrease in queries by PPD and CPD • Decrease in Grievance • Very high patient satisfaction

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