NHA is the apex body responsible for the implementation of the scheme.
“The proposal to give star ratings to both government and private hospitals empanelled under AB-PMJAY based on a set of healthcare indicators has been approved. The proposal will be implemented based on the guidelines,” J L Meena, Joint Director at National Health Authority said.
Hospitals will get ratings up to five stars based on scores on the set of elements under each domain like availability of advanced and super specialised care, patient fall rate per 1,000 patients, discharge time, patient satisfaction score compliance to quality indicators among others. And on each element, weightage, data source and scoring criteria are defined.
The weight factor will be multiplied with individual score and then overall percentage will be derived from it.
As of now, AB-PMJAY has over 23,000 hospitals on board across the country.
For 5 star rating, a hospital has to score above or equal to 90 per cent; for 4 star rating, it has to get 75 to 90 per cent; for 3 star rating, it has to get 50 to 75 per cent score; for 2 star rating, it has to score 25 to 50 per cent; while for a hospital to get 1 star rating it should have a score of less than 25 per cent.
Also, these star ratings will be reviewed on monthly basis, the guidelines stated.
“Star rating of hospitals will be published on the official website of AB-PMJAY and mobile application of PM-JAY against the name of each empanelled hospital,” said Meena.
Since the launch of AB-PMJAY in September 2018, at least 1,08,99,888 beneficiaries have availed treatment under the scheme in the country. The health insurance scheme aims to provide a cover of Rs 5 lakh to more than 10.74 crore poor in a year as a step forward towards achievement of Universal Health Coverage in India.