Stakeholders collaborate to expand Ayush insurance coverage

Ministry of Ayush hosts event to foster integration of Ayush treatments into health insurance, aiming for broader access and affordability

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New Delhi: In a bid to make Ayush treatments accessible to every patient, the Ministry of Ayush hosted a sensitization program for insurance companies and Ayush hospital owners at the All India Institute of Ayurveda (AIIA). The event aimed to discuss regulatory frameworks and policy support needed to integrate Ayush treatments into health insurance schemes.
This initiative comes in the wake of the Insurance Regulatory Development Authority of India’s (IRDAI) directive to include Ayush treatments under health insurance coverage starting April 1, 2024. The meeting highlighted the need for deeper collaboration between Ayush hospitals, healthcare providers, and insurance stakeholders to make Ayush healthcare affordable and widely available.
“The aim is to ensure easy access to Ayush treatments for everyone. A significant milestone was achieved with the joint publication of standard treatment guidelines by DGHS & Ayush (STG), marking a first-of-its-kind integration in India. The aim is to ensure easy access to Ayush treatments for everyone. This focus on accessibility is coupled with remarkable growth in the sector, with the manufacturing of Ayush products increasing eightfold in the last decade,” said Vaidya Rajesh Kotecha, Secretary of the Ministry of Ayush. 
Prof. Tanuja Nesari, Director of AIIA, highlighted “We’re making significant strides in integrating Ayush treatments into the mainstream healthcare system. Our collaboration with insurance companies focuses on enabling cashless access to Ayush services through the TPA network. Today’s meeting is a pivotal step in this journey, bringing us closer to realizing our vision of making Ayush treatments accessible and affordable for all”.
Prof. Bejon Kumar Misra, Chairman of the Core Group of Experts for Insurance at the Ministry of Ayush, underscored the need for a separate registry for Ayush hospitals, “a key recommendation is to promote Ayush HCO empanelment and Adopt MoAyush approved Standard Treatment Guidelines (STGs), ICD-TM2 codes and increase Ayush representation on key committees.”
Rajiv Vasudevan, MD & CEO of Apollo AyurVAID Hospitals, discussed, “The current insurance services are largely focused on surgical and emergency services but two-thirds of the sector belongs to people dealing with long-term diseases and effective Healthcare is required. The question is what do patients with long-standing issues, recurring issues autoimmune diseases, and neurodegenerative diseases do? It’s time to go from symptomatic relief to identifying and working on the root cause of the disease(s).  Ayush treatments will also be highly effective in case of palliative care and end-of-life care”.
The program, featuring perspectives from both the insurance sector and Ayush hospitals, covered topics such as insurance coverage, STGs, and the integration of Ayush hospitals into insurance platforms like ROHINI.
Dr. Kousthubha Upadhyaya, Adviser at the Ministry of Ayush, mentioned the formation of a Core Group of Experts for the Insurance Sector in October 2023. The group aims to monitor insurance-related matters in the Ayush sector and produce a white paper on the current status and future prospects.
Efforts are also underway to include Ayush interventions in the Ayushman Bharat-Pradhan Mantri Jan Aarogya Yojana (AB-PMJAY), according to Dr. A. Raghu, Deputy Director General (Ayush) at DGHS. He said, “A flat rate design is required since Ayush treatments require longer stays and should be classified on the basis of Rog Bal (disease strength) and the Rogi Bal (patient strength ).” 
Key speakers included Prof. (Dr.) Anandaraman P. V., Mukund Kulkarni (Head Health), Dr. Alka Kapoor (DMS, AIIA), Yogananda Tadepalli (CTO, IIBI), Segar Sampathkumar (GIC), Amit Jain (COO, Aditya Birla Health Insurance), Ram Natesan (Sr. VP, Star Health Insurance), Dr. Sunil Gala (Head of claims, Magma HDL), and Rohit Gupta (Head of group health business, SBI General Insurance).