NEW DELHI: In a move to consolidate and bring uniformity in the delivery of healthcare services including insurance and diagnostics, the government think tank Niti Aayog has proposed “strategic purchasing” of services, “risk pooling” and digitization of health to make services available and reduce health expenditure, official sources said.

The recommendations are part of a policy paper cum report set to be released by the Aayog coming Monday.

“Imagine a billion transactions every year where individual patients seek care from a million healthcare providers dominated by the private sector negotiating their own prices for the procedures they undergo. Even among the organized payers, there are multiple schemes,” the report said, highlighting that multiplicity of purchasing platforms along with highly fragmented pool of services prevents standardization. TOI has reviewed excerpts of the report.

For instance, in the public sector itself, there are various insurance schemes such as the central government health scheme (CGHS), labour ministry’s employees' state insurance corporation (ESIC), the latest Ayushman Bharat scheme for ‘deprived’ families as well as a separate insurance scheme by railways. Under all these schemes, the government purchases different healthcare services from different players at varied prices.

As per Aayog’s recommendations, a strategic purchasing of services will not only help utilize resources economically but also bring significant reduction in health expenditure, the official said.

The public health expenditure in India (total of centre and state governments) has remained constant over years at approximately 1.4% of the GDP. On the other hand, out-of-pocket payments remain common in India, with only around 20 per cent of the population covered by health insurance. Though Ayushman Bharat aims to expand the coverage significantly, it will take time and funding to ramp it up.

The report - titled ‘Health Systems for a New India: Building Blocks – Potential Pathways to Reform’ – suggests corrective measures to consolidate the highly fragmented health systems and services in both public as well as private sector.

The report also highlights the need for a digital backbone - including patient records and health stack - as well as risk pooling to bring forth a systemic reform in healthcare in India, sources said.

Similarly, digitization of health records will help inter-operability or cross-sharing, thereby potentially guiding the decisions on health policy and regulation, the official said.

The report –– is based on the data collected by Access Health International for public sector and PriceWaterhouseCoopers for the private sector.

“The vision for health in India in the next fifteen years is to transform the delivery of health services in a way that health outcomes improve at a much greater pace, without financially burdening its citizens,” the report said.

The Aayog will present the report to various relevant ministries and government departments including health ministry to develop strategy for implementations of the options suggested by it.

The Aayog, with a mandate to chart India’s road map towards meeting the targets under the sustainable development goals (SDGs) by 2030 – particularly in social sectors like health and education, have already come up with a three-year action agenda and a seven-year strategy. Currently, it is working on a 15-year vision document for the country’s development.