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Impact of Health Benefit Package Revisions on Service Utilization in Punjab's PM-JAY Scheme

Content Editor: PHC Editor

November 4, 2024 at 5:47:31 PM

PM-JAY, Health Benefit Package, Service Utilization, Health Insurance

Content Editor: PHC Editor
  • A study by Prinja S et al evaluated the effects of Health Benefit Package (HBP) revisions on service utilization under Punjab's Pradhan      Mantri Jan Arogya Yojana (PM-JAY).

  • Revisions from HBP 1.0 to HBP 2.0, including changes in package nomenclature, construct, and pricing, led to increased utilization in both      public and private hospitals.

  • Price adjustments, especially in underpriced packages, significantly boosted claims, highlighting the importance of appropriate      pricing in health insurance schemes.

  • The study used time-series analysis on 1.35 million claims, showing  that policy adjustments directly influenced provider behavior towards service uptake.

  • Findings emphasize the need for thoughtful HBP revisions to enhance accessibility and sustainability in publicly funded health insurance.

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