Only 1.29 crore of 6 crore eligible seniors enrolled in Ayushman Bharat. The slow ramp pressures hospital chains and insurers counting on government payer volume.
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Ayushman Bharat's expansion to cover all citizens aged 70 and above has enrolled only a fraction of its target population two years in. The lag weighs on hospital chains and health insurers that expected a faster ramp in government-payer volume.
Of the 6 crore senior citizens eligible under the Ayushman Vaya Vandana Yojana, roughly 1.29 crore have been approved for coverage, according to the National Health Authority dashboard. Only 63,812 Ayushman cards have been delivered.
The rollout for ASHA and Anganwadi workers shows a similar gap. Of the 72.23 lakh eligible workers, coverage has been approved for 44.1 lakh.
The National Health Authority held a two-day review meeting to push states to accelerate enrollment. Union Minister of State for Health Prataprao Jadhav said the scheme has facilitated cashless treatment worth more than ₹1.91 lakh crore through over 37,000 empanelled hospitals.
For hospital operators and health insurers, the slow enrollment means a delayed contribution from the government payer segment. Private hospital chains had expected the scheme to drive volume growth in semi-urban and rural markets. Insurers offering complementary top-up plans face a slower expansion of the insured base.
The NHA reviewed upgrades to core IT platforms covering beneficiary identification and hospital empanelment. Discussions covered a proposed framework for planned pre-authorisation of procedures and enhancements to the auto-adjudication engine for faster claims settlement. The meeting also reviewed the National Health Claims Exchange pilot, designed to enable interoperable digital exchange of health claims.
The NHA's Health Analytics and AI Unit showcased analytical tools for tracking beneficiary portability and district-level healthcare access. A presentation by AIIMS, New Delhi, covered its Clinical Decision Support System, which uses artificial intelligence to assist evidence-based clinical decision-making.
On the second day of the meeting, the NHA recognised states for their performance. Andhra Pradesh and Sikkim received awards for issuing the highest number of Vay Vandana Scheme cards per lakh population. Madhya Pradesh and Meghalaya were honoured for recording the highest number of biometric-authenticated pre-authorisations.
The NHA directed states to prioritise enrollment for senior citizens and ASHA workers. The NHA said the National Health Claims Exchange platform is expected to facilitate faster settlement of approved PM-JAY claims, enabling empanelled hospitals to access working capital without waiting for reimbursements from State Health Agencies.
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