Swasthya Sathi health insurance: 15-20% hike in rate for hospitals & nursing homes

The Bengal government has increased the rate of the health scheme, Swasthya Sathi, after private hospitals requested the state to prepare revised rates of various treatments under the insurance scheme. The prices of 33 conventional treatment packages have been increased by an average of 15-20 per cent.

The challenge for the state was to ensure that services in private nursing homes and hospitals were open to everyone availing the facility. Initially, the government had asked the authorities to take care of the treatment but the hospital authorities had requested the government to reconsider the rates of medical management of patients in general as well as critical care units. Accordingly, a committee was formed to prepare a revised rate sheet.

On Tuesday, the state released the recommendations in consultation with private hospitals and nursing home authorities. According to the revised price list, the government rate for general treatment has been increased by 20 per cent. Cardiac treatment rates have risen by 25 per cent and the general surgery has been increased by 15-20 per cent. Considering all the changes among the 105 most common packages, 80 per cent is being covered under this. The state has also said that discussions will be held with the hospital-nursing home authorities in the coming days further to resolve other issues.

Revised rates mean that the overall cost will increase from 8-10 per cent, that is, by Rs 200 crore. More than 20 million families have been receiving benefits under Swasthya Sathi, and since December 2020, six lakhs new families have come under it. Currently, about 3,600 people are taking the service daily. So far, 6 lakhs people have been given the health insurance cards. Another 6 million people will be covered under it in the coming days, said officials. There are 1,536 private hospitals and 425 new ones under the scheme that has about 1.22 lakh government and private beds.

Chief Secretary Alapan Bandyopadhyay Tuesday said, “The government has promised to revise various package-rates for healthcare in consultation with the directors of hospital-nursing homes.”

As per the decision of the government, the earlier rates for ICU services in Grade-A and Grade-B were Rs 3,000 and Rs 1,500 respectively. It has increased to Rs 3,300 and 1,800 respectively. Cardiothoracic and Vascular Surgery (CTVS) for heart disease now has a government rate of Rs 60,000 to Rs 1,60,000. That has increased from Rs 1 lakh to 2.1 lakh.

“We are happy with the decision,” said Rupak Barua, president of the East India Association of Private Hospitals. The only problem is with the ICU-ICCU-ITU charge. It has been increased from Rs 3,000 to Rs.3,300 rupees. However, in one day it costs more than Rs.20,000. We have informed the government about this. We have been informed that it will be reconsidered,” Barua said.