Service providers want transparency in payment system
The incidence of end-stage kidney disease is estimated at 150-230 per million and about 2,20,000-2,75,000 new patients need Renal Replacement Therapy every year.
It took just 40 days for the health ministry to roll out the national dialysis care programme across the country after finance minister Arun Jaitley had announced the scheme in the Union Budget.
Launched with technical support from national health systems resource centre (NHSRC), the scheme aims to provide dialysis care in every district across the country .
On April 7, the ministry released the guidelines setting up the dialysis centres under public private partnership. The ministry has also prepared model tender documents.
The guideline and the model document will help states to invite tenders from private players for equipments etc. “States have been asked to start deliberation on the programme at the earliest,” an official said. The scheme is part of the National Health Mission.
“Looking at the increasing number of patients suffering from End Stage Kidney Diseases (ESKD), the initiative of the ministry to push for more dialysis centres through the PPP model is a boon,” George Institute for Global Health India executive director Vivekanand Jha said.
However, experts say the government needs to bring in more clarity in details on payments to the service providers as that may affect services. “The basis of the payments need to be worked on.Will the payments be made on the basis of processing of requirements or will it be based on outcome parameters? ESKD care goes beyond provision of dialysis, as other aspect of disease (like reduced production of blood cells, abnormal bone health, and cardiovascular disease) need to be managed alongside,” Jha said.
Experts suggest payment for such services should either be “bundled” with that for dialysis, or covered through a separate scheme. The ideal payment model should be based on a combination of process and outcome measures.
Of late, the health ministry has undertaken several measures to strengthen the primary healthcare system, mainly through district hospitals. “The objective is to provide affordable multispeciality care closer to home across the country. While this would increase accessibility, it would also reduce load from tertiary care facilities,” the official said.
Estimates show kidney failures among Indians has doubled in the last 15 years.
The incidence of end-stage kidney disease is estimated at 150-230 per million and about 2,20,000-2,75,000 new patients need Renal Replacement Therapy (RRT) every year.