Over three decades after user fees were introduced in public hospitals, the Brihanmumbai Municipal Corporation (BMC) is preparing to transform patient care by making hospitalisation a “cashless experience.”
BMC Launches Integrated Patients Healthcare Scheme Assistance System (IPHSA)
To achieve this, the civic body has established the Integrated Patients Healthcare Scheme Assistance System (IPHSA). The new system aims to connect most patients visiting BMC’s super-specialty and suburban hospitals with central or state government health aid and insurance schemes.
Last week, the BMC invited bids from agencies to operate IPHSA across the city’s four healthcare zones. Each selected agency will be responsible for coordinating patient benefits and ensuring seamless access to eligible schemes.
Leveraging Government Schemes for Funding
As reported by TOI, the idea for IPHSA emerged during discussions within the public health department. “Public hospitals in southern states actively claim reimbursements under various state and union government schemes. With IPHSA, we too can seek similar funding for our patients,” said a civic official.
Currently, BMC hospitals collect around ₹100 crore annually from in-patient services. Officials estimate that with IPHSA’s efficient linkage to government schemes, this figure could increase tenfold through proper documentation and reimbursement.
Ensuring Cashless Treatment for Patients
Under IPHSA, patients will no longer need to pay for surgeries, diagnostic scans, or post-operative medicines. “For example, the Employees’ State Insurance Corporation (ESIC) provides medicines such as statins under its scheme, but many beneficiaries are unaware of it. IPHSA can bridge this gap and ensure patients receive their entitled benefits,” explained a senior civic official.
In addition to popular initiatives like Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and the Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJY), the system will help patients access lesser-known central schemes such as Rashtriya Arogya Nidhi—which offers up to ₹25 lakh in assistance—and the Health Minister’s Discretionary Grant.
Reducing Out-of-Pocket Healthcare Expenses
Deputy Municipal Commissioner Sharad Ughade said, “The IPHSA system will coordinate between hospital administrations and patients. The aim is to reduce the out-of-pocket expenditure for healthcare.”
Agencies operating IPHSA will receive a commission for every patient case successfully linked to a government scheme.
Strengthening Civic Healthcare Infrastructure
The initiative aligns with Chief Minister Devendra Fadnavis’s recent announcement about revising the ceiling for treatment costs under MJPJY. A BMC press release stated, “This system will enable civic hospitals to effectively implement all central and state health schemes. It will also unlock significant funds to strengthen the civic healthcare system.”
Expert Views and Concerns
While the initiative has been widely welcomed, some experts have raised questions about its design. Health economist Dr. Ravi Duggal remarked, “Why should there be a separate mechanism to help people avail government schemes? Such support should already be integrated into the public healthcare system.”
Towards Universal and Affordable Healthcare
By launching IPHSA, the BMC aims to modernize hospital administration, reduce financial barriers for patients, and expand access to government-funded healthcare. If implemented effectively, the system could mark a crucial step toward making public hospitalisation in Mumbai truly cashless and inclusive.