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Concise Overview
This Report of the Comptroller and Auditor General of India contains results of the Performance Audit on Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) covering the period September 2018 to March 2021.
Ayushman Bharat is a health scheme of the Government of India launched on 23 September 2018 to achieve Universal Health Coverage as recommended in the National Health Policy, 2017 which envisages the attainment of the highest possible level of health and well-being for all at all ages.
Ayushman Bharat comprises of two inter-related components viz. i) Health and Wellness Centres and ii) Pradhan Mantri Jan Arogya Yojana.
First component of Ayushman Bharat is the creation of Health and Wellness Centres by transforming Primary Health Centres/Sub-Centres to provide Comprehensive Primary Health Care. This will enable a focus on wellness and health promotion, provide an expanded range of primary healthcare services, including access to medicines and diagnostics, to be delivered close to the community. The objective is to set up 1,50,000 HWCs by December 2022 in order to facilitate universal health coverage and reduce out of pocket expenditure. As on 30 November 2022, 1,31,150 HWCs were functional.
The Second component of Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (PMJAY) provides a health cover up to ₹ five lakh per family per year, for secondary and tertiary care hospitalization services. PMJAY provides cashless and paperless access to services for the beneficiaries at the point of service.
The Scheme has been rolled out in rural and urban areas, based on the deprivation and occupational criteria of the Socio-Economic Caste Census, 2011 (SECC-2011) respectively, for over 10.74 crore families. Aim of the Scheme is reduction in out-of-pocket expenditure of poor and vulnerable population. In January 2022, GoI approved the expansion of beneficiary base to 12 crore families based on National Food Security Act data. As per National Health Authority (NHA) records, 7.87 crore beneficiary households were registered, constituting 73 per cent of the targeted households of 10.74 crore (November 2022).