Page 311 - ES 2020-21_Volume-1-2 [28-01-21]
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294     Economic Survey 2020-21   Volume 1


                          Figure 3a: Number of pre-authorised claims July 2018-January 2021


















                  Source: NHA data secured from PMJAY. Data for January 2021 is till 13-Jan-2021.

             9.18  Second, the number of dialysis claims have only been growing. This fact highlights that
             the National Dialysis Mission could be merged with PM-JAY.

             9.19  Third, while access to medical services were classified as essential services during the
             lockdown, care-seeking exhibited a V-shaped behaviour during the lockdown and unlock phases
             with the pre-CoVID-19 levels being reached in December 2020.  The V-shaped behaviour
                                                                              11
             is likely to be due to both demand and supply side effects. on the supply side, health care
             workers might have cut back on services out of initial fear of infection or it is possible that
             pre-authorization processes were skipped. Further, many private hospitals were not providing
             services for fear of infection and government hospitals were reserved for CoVID-19 patients.
             on the demand side, patients avoided hospitals due to fear of contracting the virus, or their
             access to medical services could have been impeded by lack of transport or finances during the
             lockdown. Both the demand and supply side factors seem to have since recovered completely
             during the unlock phase. Further, recovery in private sector hospitals in much better than the
             public empaneled healthcare providers (EHCP).

             9.20  Next, figure 3b plots the gap between volume of pre-authorised claims which are <2500
             INR and >2500 INR.
                     Costly procedures are preferred early into the adoption of PM-JAY; COVID recovery being led by non costly procedures
             Figure 3b: Gap between volume of pre-authorised claims and the pre-authorised amount of INR 10,000

                                                                    COVID
                      6,00,000  Number of of Procedures with pre-auth amount <2500 INR   Recovery being led
                     Number of Pre-authorized claims/month   4,50,000
                      5,50,000
                                                                                         by non costly
                                                                                         procedures
                      5,00,000
                              Number of of Procedures with pre-auth amount >2500 INR
                      4,00,000
                      3,50,000
                      3,00,000
                      2,50,000
                      2,00,000
                      1,50,000
                      1,00,000
                      50,000
                         0
                         Jul-18   Sep-18   Nov-18   Jan-19   Mar-19   May-19   Jul-19   Sep-19   Nov-19   Jan-20   Mar-20   May-20   Jul-20   Sep-20   Nov-20   Jan-21
                  Source: NHA data secured from PMJAY

             11 PM-JAY  policy  brief:  https://pmjay.gov.in/sites/default/files/2020-06/Policy-Brief-8_PM-JAY-under-Lock-
             down-Evidence_12-06-20_NHA_WB.pdf
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