Ayushman Bharat at Scale: 180,000 Arogya Mandirs and 42 Crore Health Cards

New Delhi: When India began rolling out Ayushman Bharat, the ambition went far beyond insurance coverage or infrastructure upgrades. It sought to redesign the very architecture of healthcare delivery—placing prevention before cure, community before hospitals, and continuity before episodic care. Today, as the programme matures, Ayushman Bharat stands as one of the most comprehensive public health transformations attempted anywhere in the world.

Unlike conventional health initiatives that operate in silos, Ayushman Bharat was conceived as an integrated system. Its four pillars—primary healthcare transformation, financial protection, infrastructure strengthening, and digital health—work in concert to address healthcare needs across a person’s lifetime.

The Frontline of Care: Health Moves Closer to Home

At the heart of Ayushman Bharat is a quiet but profound shift: healthcare no longer begins at the hospital gate. It begins in the community.

This vision has taken shape through Ayushman Arogya Mandirs—nearly 1.82 lakh neighbourhood-level health facilities created by upgrading Sub Health Centres and Primary Health Centres across rural and urban India. These centres, once limited to maternal and child health services, have been reimagined as hubs of Comprehensive Primary Health Care (CPHC).

Today, an Ayushman Arogya Mandir is as likely to screen a middle-aged farmer for hypertension as it is to conduct antenatal check-ups or provide childhood immunisation. Services now extend to non-communicable diseases such as diabetes and cancer, mental health support, geriatric and palliative care, trauma services, and wellness interventions including yoga.

This shift reflects a fundamental insight: 80 to 90 percent of an individual’s healthcare needs can be addressed at the primary care level. By detecting disease early and managing chronic conditions close to home, the system reduces avoidable hospitalisations while improving quality of life.

The scale is unprecedented. By November 2025, Ayushman Arogya Mandirs had recorded nearly 495 crore patient visits and facilitated over 41 crore teleconsultations. Preventive screenings—often the weakest link in healthcare systems—have reached hundreds of millions, with more than 39 crore screenings for hypertension and over 36 crore for diabetes alone. Cancer screenings for oral, breast, and cervical cancers have similarly expanded, bringing early detection within reach for populations historically excluded from routine care.

Insurance with Impact: Financial Protection at National Scale

Primary care, however, is only one piece of the puzzle. Serious illness can still push families into poverty without financial protection—a reality Ayushman Bharat confronts through the Pradhan Mantri Jan Arogya Yojana (PM-JAY).

Launched as the world’s largest publicly funded health insurance scheme, PM-JAY provides cashless coverage of ₹5 lakh per family per year for secondary and tertiary hospitalisation. For millions of households, this has meant the difference between timely treatment and delayed care, between recovery and lifelong debt.

As of December 2025, around 12 crore families are covered under PM-JAY, with several states expanding eligibility beyond national norms. More than 42 crore Ayushman Cards have been issued, unlocking access to a nationwide network of over 32,500 empanelled hospitals, nearly half of them in the private sector.

The numbers tell a compelling story. Nearly 11 crore hospital admissions worth ₹1.60 lakh crore have been authorised under the scheme. Just as significant is who is accessing care: women account for nearly half of all beneficiaries, marking a decisive step toward gender equity in healthcare.

In October 2024, the programme expanded further with the launch of the Ayushman Vay Vandana Card, extending PM-JAY benefits to all citizens aged 70 and above, regardless of income or socio-economic status. For a rapidly ageing nation, this move signals a shift toward universal health security in later life.

Building Capacity for Tomorrow’s Crises

If PM-JAY protects households, the Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) strengthens the system itself.

Launched in the shadow of the COVID-19 pandemic, PM-ABHIM is a forward-looking investment in resilience. With an outlay of over ₹64,000 crore, it aims to upgrade health infrastructure across primary, secondary, and tertiary levels—while preparing India for future public health emergencies.

The mission envisions a nationwide disease surveillance network, modern laboratories in every district, block-level public health units, and critical care hospital blocks capable of handling surges in demand. From urban slums to remote districts, PM-ABHIM is filling gaps that long constrained India’s health response capacity.

Progress is already visible. Thousands of Ayushman Arogya Mandirs are being strengthened under the mission, alongside the creation of integrated public health laboratories and critical care facilities. Several AIIMS and premier medical institutions are establishing 150-bedded Critical Care Hospital Blocks, equipped with advanced ICUs, isolation wards, and emergency services.

Equally important is the mission’s emphasis on research and the One Health approach—recognising that human health is deeply interconnected with animal and environmental health. In an era of zoonotic diseases and climate-linked health risks, this integration is no longer optional.

A Digital Thread Connecting Care

What binds these physical systems together is the Ayushman Bharat Digital Mission (ABDM), India’s attempt to create a unified digital health ecosystem.

At the centre of ABDM is the Ayushman Bharat Health Account (ABHA), a digital health ID that allows individuals to securely store and share medical records with consent. For patients who move between cities or providers, this continuity can be transformative—eliminating repeated tests, reducing errors, and improving clinical decision-making.

Behind the scenes, ABDM operates through a set of national registries for health professionals, facilities, and drugs, along with digital gateways that enable interoperability across platforms. Together, they create the digital trust layer required for a modern health system.

While challenges remain—particularly around adoption, data literacy, and integration—the foundations of a connected healthcare ecosystem are now firmly in place.

From Scheme to System

Taken together, Ayushman Bharat represents more than the sum of its parts. It is not merely a welfare scheme or an insurance programme; it is a systems-level reimagining of how healthcare is delivered, financed, and governed in a country of 1.4 billion people.

By strengthening primary care, protecting families from financial shock, investing in infrastructure, and enabling digital continuity, Ayushman Bharat is shifting India’s health narrative—from reactive treatment to proactive care, from fragmented services to coordinated systems.

The journey is far from complete. But as the numbers accumulate and institutions mature, one conclusion is increasingly clear: Ayushman Bharat is not just expanding access to healthcare—it is redefining what universal health coverage means for India in the 21st century.