To improve the quality of private hospitals empanelled under the Ayushman Bharat Yojana, the Madhya Pradesh Health Department has made National Accreditation Board for Hospitals (NABH) certification mandatory for hospitals in Bhopal, Indore, Gwalior and Jabalpur. Hospitals in these four cities will be allowed to provide treatment under medicine packages only if they have final NABH certification. For empanelment under other packages, at least entry-level NABH certification will be required.
The new system will come into effect from October 1. The Health Department had initially planned to implement the condition from April 1, but hospital operators met Chief Minister Mohan Yadav and sought additional time. The government subsequently granted a six-month extension.
Health Department officials have now made it clear that the deadline will not be extended further. The decision is expected to affect around 250 hospitals in Bhopal, Indore, Gwalior and Jabalpur. However, hospitals offering a large number of packages and treating a high volume of patients have started working towards entry-level NABH accreditation.
Under the revised requirements, these hospitals will have to obtain final NABH certification within six months. NABH accreditation will not be mandatory for hospitals in districts outside the four major cities. However, hospitals with NABH certification will receive relaxation in the empanelment process. For instance, hospitals with 50 beds or more can be empanelled on the basis of the CMHO's report alone.
Currently, 816 private hospitals are empanelled under the Ayushman Bharat scheme in Madhya Pradesh. Of these, 465 hospitals, or 57 per cent, are located in the four major cities. At the same time, there are 90 blocks in the state where not a single private hospital is empanelled under the scheme. Hospitals in these blocks will be given some relaxation in the eligibility conditions.
Why Are Private Hospitals Opposing The NABH Condition?
According to a nursing home operator, the NABH accreditation process itself costs around Rs 5 lakh, apart from expenses related to inspectors' travel and accommodation. Hospitals also have to spend significantly on additional staff, record maintenance, equipment and infrastructure to meet NABH standards. As a result, a 50-bed hospital may have to spend around Rs 40 lakh annually to maintain the required standards.
Hospital operators also argue that the cost of materials has increased by around 25 per cent since the COVID-19 pandemic, while Ayushman Bharat package rates have not increased. In some cases, the rates have actually been reduced.
For example, the reimbursement for a dialysis cycle was earlier Rs 2,250. It is now Rs 1,485 for NABH hospitals and Rs 1,350 for non-NABH hospitals. Hospital operators also claim that payments are often delayed by three to four months. They have further questioned why the NABH requirement is being imposed in only four cities and not across the state.
How Many Private Hospitals Are There In These Four Cities?
- Bhopal: 228
- Indore: 90
- Gwalior: 79
- Jabalpur: 68
Hospitals Seek Alternative To NABH
Private hospital operators argue that there are other quality-assurance options apart from NABH, including QCI-CGHS. They say that obtaining NABH accreditation requires hospitals to significantly increase their resources, resulting in an additional annual expenditure of at least Rs 40 lakh.
Dr Sanjay Gupta, President of the Nursing Home Association's Bhopal branch, said that no other state has made such a requirement mandatory and argued that alternative quality-assurance mechanisms should also be considered.