Key stakeholders recently gathered at the All India Institute of Ayurveda (AIIA) to discuss the regulatory framework and policy support needed to mainstream Ayush treatments within health insurance schemes.

The sensitization program, organized by the Ministry of Ayush for insurance companies and Ayush hospital owners, aimed to make Ayush treatments accessible to patients across all regions.

This meeting was prompted by the Insurance Regulatory and Development Authority (IRDAI) directive to include Ayush treatments under health insurance coverage, effective April 1, 2024. The discussions focused on fostering a deeper understanding between Ayush hospitals, healthcare providers, and insurance sector stakeholders to make Ayush healthcare more affordable and accessible.

Vaidya Rajesh Kotecha, Secretary, Ministry of Ayush, emphasized the goal of ensuring easy access to Ayush treatments for everyone. “A significant milestone was achieved with the joint publication of standard treatment guidelines by DGHS & Ayush (STG), marking a first-of-its-kind integration in India. This focus on accessibility is coupled with remarkable growth in the sector, with the manufacturing of Ayush products increasing eightfold in the last decade,” he said.

Prof. Tanuja Nesari, Director, All India Institute of Ayurveda (AIIA), highlighted their collaboration with insurance companies to enable cashless access to Ayush services through the TPA network.

Prof. Bejon Kumar Mishra, Chairman, Core Group of Experts for Insurance, Ministry of Ayush, discussed the need for a separate registry for Ayush hospitals. He recommended promoting Ayush Healthcare Organizations (HCO) empanelment, adopting Ministry of Ayush-approved Standard Treatment Guidelines (STGs), ICD-TM2 codes, and increasing Ayush representation on key committees.

Rajiv Vasudevan, MD & CEO of Apollo AyurVAID Hospitals, addressed the current state of insurance services, noting that they largely focus on surgical and emergency services. "Two-thirds of the sector deals with long-term diseases that require effective healthcare. It's time to move from symptomatic relief to addressing the root cause of diseases. Ayush treatments are also highly effective in palliative and end-of-life care," he added.

Prof. Mishra further noted the expectation for the General Insurance Council to lead the initiative, involving its 39 general, standalone health, reinsurance, and specialized insurance companies in publishing a comprehensive White Paper.

Dr. Kousthubha Upadhyaya, Adviser, Ministry of Ayush, mentioned that the Ministry of Ayush constituted a Core Group of Experts for the Insurance Sector in October 2023. This group is tasked with advising and monitoring insurance-related matters in the Ayush sector, conducting a study on the current status of Ayush systems under health insurance, and creating a white paper.

Additionally, the Ministry of Ayush and the National Health Authority (NHA) are working towards including Ayush interventions in the Ayushman Bharat-Pradhan Mantri Jan Aarogya Yojana (AB-PMJAY), Dr. Upadhyaya added.

Dr. A. Raghu, Deputy Director General (Ayush), emphasized the need for systematic derivation of treatment durations for each disease across mild, moderate, and severe levels of medical management. He highlighted that package inclusions and exclusions should be clearly defined based on a duration x per day rate model.

The event concluded with a commitment to continue collaborations and discussions to ensure the successful integration of Ayush treatments into health insurance schemes, aiming to benefit a wider range of patients and improve overall healthcare outcomes.