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DHN EXCLUSIVE: Decoding Healthcare Expectations from Modi 3.0

Written by : DHN Bureau

June 10, 2024

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As Narendra Modi took charge as the Prime Minister of India for the third consecutive year, the Indian healthcare industry hailed PM Modi’s stellar leadership and expressed confidence in directing the country towards inclusive growth.

In the realm of healthcare, the Modi administration has achieved significant milestones, including the implementation of its flagship program - Ayushman Bharat, adeptly managing the COVID-19 crisis, and distributing vaccines globally.

However, critical gaps remain that need addressing, such as insufficient fund allocations from the state governments towards the Ayushman Bharat scheme, which led to the withdrawal of private hospitals in several states.

Besides, implementation of different health schemes reaching across different states, and decreasing healthcare cost by expanding the healthcare delivery etc are major expectations of healthcare leaders.

Further, focusing on outcome-based delivery to reduce private & public healthcare costs, too found prominence in the voice echoed by industry experts.

As Modi 3.0 started rolling, DHN spoke to these eminent leaders to delve into the healthcare industry's expectations and hopes for the future.

NHA’s Flagship Program

The standout achievement is certainly the Ayushman Bharat Scheme. Discussing this, Dr Nandkumar Jairam, chairman, Medica Synergie Hospitals, advisor at Sheares Healthcare India, chairman of Shayamrad, and president of GAPIO, said, “The Ayushman Bharat scheme has helped immensely in improving access to healthcare. However, the reimbursement to providers is still far from adequate. Sometimes even lower than the cost of delivery. It is requested that the payment be significantly increased and reviewed once more.’’

While the Karkinos CIO - Arvind Sivaramakrishnan also recommends Ayushman Bharat for all sections with a co-pay for the tax-paying class, which will emphasize value-based care outcomes.

Talking to DHN, Bharat Gera, founder, Human Centric Healthcare Ecosystem, said, “I was expecting that ABDM would be made mandatory by Modi 3.0 - now with the coalition mandate I have doubts whether it will be possible or even be a priority. ”

Medical Device Manufacturing & Separate Regulatory Framework

In discussing Medical Device Manufacturing & Separate Regulatory Framework, Rajiv Nath, forum coordinator at the Association of Indian Medical Device Industry (AiMeD), emphasized the need for the government to prioritize boosting manufacturing and establishing a predictable tariff regime. He stressed the importance of monitoring and regulating labeled prices of Medical Devices to prevent patients from being exploited with artificially inflated prices.

“We expect the government to boost manufacturing of medical devices and bring in a predictable tariff regime that makes manufacturing viable without being overly protectionist and instead focuses on monitoring and regulations of labeled prices of Medical Devices as that’s what is charged to consuming patients and they are currently being taken for a ride with artificially inflated prices,” forum coordinator Nath stated.

He also stressed encouraging fair marketing based on quality and value, not on pushing products with high-profit margins.

“For a while now, we've been asking for rules that stop companies from artificially raising prices on medical device labels. This practice hurts honest manufacturers and marketing companies. Instead, we want fair competition based on the real value of the products, not inflated prices,” Nath added.

Additionally, he talked about a separate regulatory framework for Medical Devices that would ensure patient safety and quick access to affordable innovative options while keeping manufacturers disciplined and acting responsibly.

Expressing thoughts on the same, Dr Vivek Desai, founder & MD, HOSMAC, called medtech as the sunrise sector under the ‘Make in India’ initiative. According to him, efforts must be intensified to reduce imports, which currently stand at $4.1 billion, and boost domestic production to reduce dependency.

Primary Care

However, Dr Jairam noted that no mandated primary care service exists, which increases healthcare costs. According to him, creating a "gatekeeper " concept and insisting on primary care being the first port of call will vastly improve care and reduce costs.

“Health is currently a state subject. Therefore, uniform implementation of schemes is problematic. If it comes under the concurrent list, this will increase the speed of implementation,” added the Medica Synergie chairman.

According to Dr Desai, attention is needed for implementing Electronic Health Records (EHR) through the Ayushman Bharat Digital Mission. EHRs reduce medical errors and enhance patient care.

Public Private Partnership

Sharing views, Prof K Ganapathy, a digital health evangelist with five decades of clinical experience, said, “Half the battle is won, if there is continuity of care. This does not apply to governance alone (!) but also in making available all health records of every individual, with the highest level of privacy and security, to any authorized individual anytime, anywhere. PPP in Healthcare needs to be escalated. Pilots and PoC in Modi 1.0 and 2.0 must give way to mega projects in Modi 3.0. WiiiFM (What is in it For Me) needs to be addressed, taking into account every stakeholder in the ecosystem.”

Leveraging GenAI

On expectations from the new government, many also emphasized leveraging Gen AI, as Vishnu Vardhan, founder and CEO of Vizzhy Inc.,  stated, “The prevalence of NCDs is increasing exponentially. There are 100 million diabetics, 136 million pre-diabetics, 315 million hypertensives, and 245 million obese people. This needs comprehensive attention with preventive and personalized medicine. Leveraging Gen AI and the latest multi-omics data we can treat and manage these diseases before they cause serious health problems and complications at a massive scale without overwhelming the current health system. We need policy and action on this front from National Health Mission.'' 

Sharing his thoughts on the same, Gera, said, “Other than ABDM, expecting strong support for AI/ML/Deep tech startups in healthcare - my suggestion would be to support them for commercialization beyond the product development phase supported by incubators/grants. India has the potential to be a leader in AI for healthcare.’’

According to Sivaramakrishnan, there must be a focus on the execution of digitalization for healthcare delivery along with outcome-based healthcare delivery to reduce the gap between public and private institutions.

“PF options for unorganized labor class such as household help, personal drivers, etc, so that there is about Atma Nirbharta across working classes. Thereby, entrepreneurs at all levels will be incentivized. This will reduce the mad rush for govt jobs,” he stated.

Additionally, he suggests rolling out of National Education Policy (NEP), which will be a paradigm change in skilling for the future of a real Viksit and Atma Nirbhar Bharat. This will bring thrust to innovation and local manufacturing. He believes the new NEP can make India for the world.

Standardization of Private Healthcare Costs

Dr Desai emphasized the pressing need for meaningful healthcare reforms in the incoming government's term. He stressed that urgent attention and decisive action are required to capitalize on the unparalleled opportunities in the healthcare sector.

Dr Desai also highlighted the necessity for swift standardization of private healthcare costs, citing the exorbitant fees charged by some private hospitals that hinder access to essential medical services for the lower and middle socioeconomic class. However, he applauded the Ministry of Health's previous initiative to consult with state governments for nationwide uniform charges and urged the government to expedite this process to ensure healthcare affordability and accessibility.

Integrating healthcare schemes horizontally is crucial, he noted, especially with nearly 400 million Indians lacking health insurance coverage. Harmonizing various initiatives would streamline access to insurance.

Moreover, he also highlighted the relevance of promoting sustainable healthcare facilities, including mandatory GRIHA 3 rating or silver-rated Green Building Certification for all hospitals, which Dr Desaid noted is essential to meet SDG goals by 2030. This ensures environmental sustainability and improves patient outcomes, the HOSMAC founder added.

Incentivization of Healthcare Providers

Commander Navneet Bali, CEO of ClearMedi Healthcare, emphasizes the significance of Modi Government 3.0's swearing-in, foreseeing a promising win-win scenario for the nation. He underscores the need for cohesive schemes and initiatives, particularly highlighting the potential inclusivity in Ayushman Bharat's implementation.

According to him, incentivizing healthcare providers through early reimbursements and streamlined bill processing is crucial for the scheme's success. 

''I see great scope of inclusivity in the implementation of Ayushman Bharat. For this well-curated scheme to be successful, it is crucial to incentivize healthcare providers through early reimbursements and streamlined bill processing for better adoption. Including the "missing middle" among the beneficiaries with a small premium could be a pivotal manoeuvre. Additionally, strengthening preventive health checkup programs is essential as we strive to build a healthier nation,” noted Commander Bali.

From urgent reforms in private healthcare costs to fostering domestic medical device manufacturing, and leveraging Gen AI, Electronic Health Records (EHR), and Public-Private Partnerships (PPPs), the industry is poised for transformative change.

As voices from various stakeholders echo demands for streamlined policies, incentivized healthcare providers, and heightened focus on preventive measures, the stage is set for a robust healthcare ecosystem under the new government. With JP Nadda at the helm, the vast healthcare industry remains optimistic, anticipating substantial progress and innovation in the days ahead.

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