ESIC Approves Convergence Of ESI Scheme With Ayushman Bharat PM-JAY

 In a step to boost healthcare accessibility, the Medical Benefit Council of the Employees' State Insurance Corporation (ESIC) has approved the convergence of the ESI scheme with the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY). The decision was made during the 86th Meeting of the Medical Benefit Council held at ESIC headquarters in New Delhi on Friday. This convergence is expected to expand the reach of healthcare services to a larger number of beneficiaries under both schemes.

Ashok Kumar Singh, Director General of ESIC, chaired the meeting where this pivotal decision was announced. The Ministry of Labour and Employment issued a statement detailing the benefits of the convergence. The Ayushman Bharat PM-JAY, the largest health assurance scheme globally, provides health coverage of Rs 5 lakh per family per year for secondary and tertiary care hospitalization. This scheme covers over 12 crore poor and vulnerable families, approximately 55 crore beneficiaries, which account for the bottom 40 per cent of India's population.

Strengthening Healthcare Services through Convergence

The decision to converge the ESI scheme with Ayushman Bharat PM-JAY will significantly improve access to healthcare services for beneficiaries of both schemes, ensuring that insured persons (IPs) under ESIC can benefit from the extensive network and health assurance provided under PM-JAY. This convergence is aimed at enhancing the scope and quality of healthcare services available to beneficiaries, making it easier for them to access comprehensive medical treatments, particularly for hospitalization.

Other Key Approvals: Common Support Mission and Preventive Health Initiatives

In addition to the scheme convergence, the Medical Benefit Council also approved the implementation of the Common Support Mission (CSM) across states. This mission aims to strengthen and enhance ESI’s medical service delivery system, focusing on improving healthcare access and quality for insured persons. By adopting an IP-centric approach, the CSM will work towards ensuring that ESI's medical services meet the evolving needs of the beneficiaries.

The Council also greenlit the launch of annual preventive health check-ups and awareness camps for ESI beneficiaries. These initiatives will target early detection of lifestyle disorders, identifying pre-cancerous lesions, and addressing nutritional deficiencies among insured persons, including women and transgender individuals. By promoting preventive care, the initiative seeks to reduce the overall burden of lifestyle-related diseases and ensure early diagnosis for better health outcomes.

Senior Officials and Government Representatives in Attendance

The meeting was attended by several key figures, including T L Yaden, Financial Commissioner; Deepika Govil, Medical Commissioner, ESIC; and other senior officers from the corporation. Representatives from both state and central governments were also present, underscoring the collaborative efforts to improve healthcare delivery through the ESI scheme.

Impact of Convergence on Healthcare Accessibility

The convergence of the ESI scheme with Ayushman Bharat PM-JAY is expected to significantly broaden healthcare access for millions of beneficiaries. With PM-JAY already serving a substantial portion of India’s population, particularly the economically vulnerable, this move will further ensure that the insured persons under ESIC can seamlessly access a wider range of healthcare services.

In summary, this decision is a major leap towards expanding healthcare access and improving the quality of medical services available to ESI beneficiaries, while also leveraging the scale and reach of Ayushman Bharat PM-JAY. The additional measures approved during the meeting, including the Common Support Mission and preventive health check-ups, further demonstrate ESIC's commitment to holistic and inclusive healthcare reform.