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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