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GOVERNMENT OF INDIA
MINISTRY OFHEALTH AND FAMILYWELFARE
DEPARTMENT OF HEALTH AND FAMILYWELFARE
RAJYASABHA
STARRED QUESTION NO. 340*
TO BE ANSWERED ON THE 24th MARCH, 2026
PERFORMANCE OFPM-JAY
*340 SHRI PRAMOD TIWARI:
Will the MINISTER OF HEALTH AND FAMILY WELFARE be pleased to
state:
(a) the latest assessment of the Pradhan Mantri Jan Arogya Yojana (PM-JAY) in
improving access to quality healthcare;
(b) whether in a number of States private hospitals empanelled under the Yojana have
suspended services;
(c) if so, the details thereof and the reasons therefor;
(d) whether the Yojana has failed to reduce out-of-pocket expenditure; and
(e) if so, the reasons therefor including steps taken to reduce cost of care and out-of-
pocket expenditure?
ANSWER
THE MINISTER OFHEALTH AND FAMILYWELFARE
(SHRI JAGAT PRAKASH NADDA)
(a) to (e) AStatement is laid on the Table of the House.STATEMENT REFERRED TO IN REPLY TO RAJYASABHA
STARRED QUESTION NO. 340* FOR 24th MARCH, 2026
(a) to (e) Ayushman Bharat - Pradhan Mantri-Jan Arogya Yojana (AB-PMJAY) follows
standard treatment guidelines to standardize clinical practices and ensure quality and
appropriate care for eligible beneficiaries. Under AB-PMJAY, a structured incentivisation
framework has been incorporated to promote access to quality healthcare and strengthen
service delivery. The scheme provides graded financial incentives on package rates to
empanelled hospitals based on their quality certifications, including 5% for Bronze
Quality Certification, 10% for NABH Entry Level and 15% for full NABH or NQAS
accreditation, thereby encouraging hospitals to adopt and maintain recognized quality
standards.
As regards access to quality healthcare, according to a study published by The Lancet,
AB-PMJAY has significantly improved timely cancer treatment initiation, which reflects
better access to quality healthcare and easing financial burden.
Under AB-PMJAY, hospital empanelment isa continuousprocess and is undertakenby the
implementing States/UTs based on the requirements and availability of healthcare
providers meeting the criteria within a given State/UT as per empanelment guidelines of
National Health Authority. The empanelment of private hospitals under the scheme is
entirelyvoluntary.
As on 28.02.2026, the number of hospitals empanelled under the scheme has increased
significantly from 6,917 hospitals (including 3,904 private hospitals) in FY 2018–19 to
36,229 hospitals (including 16,746 private hospitals). All eligible beneficiaries under the
scheme can avail treatment through a network of these 36,229 empanelled hospitals
across the country.
AB-PMJAY provides health coverage of Rs. 5 lakh per family per year for secondary and
tertiary care hospitalization to 12 crore families constituting bottom 40% of India’s
population.Additionally, in March 2024, approximately 37 lakh families of Accredited
Social Health Activists (ASHA), Anganwadi Workers (AWW) and Anganwadi Helpers
(AWH)wereincludedunderthescheme.Theschemewasfurtherexpandedtocover6crore
senior citizens of age 70 years and above belonging to 4.5 crore families irrespective of
theirsocio-economicstatus.The Economic Survey 2024-25 highlights AB-PMJAY’s impact in reducing
Out-of-Pocket Expenditure (OOPE) through increased social security and primary health
spending, with recorded savings over Rs. 1.25 lakh crore. Further, as per the National
Health Account Data for 2021-22, Government Health Expenditure has increased from
29% to 48%, while OOPE declined from 62.6% to 39.4%, between FY 2014-15 and FY
2021-22.
As on 28.02.2026, a total of 11.69 crore hospital admissions amounting to Rs. 1.73 lakh
crore have been authorized under the scheme. The significant utilization of the scheme
indicates that eligible beneficiaries are able to access healthcare services and thereby
reduce their OOPE.
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