Chapter 11: Leveraging InsurTech for Public Health Delivery: A Study of Ayushman Bharat Scheme and Its Efficacy in Select Districts of Telangana, India

Digitalisation in India has significantly impacted various sectors of the economy by integrating automation to enable speed, accessibility, and efficiency. The COVID-19 pandemic has further emphasised the need for creation of a robust and sustainable digital healthcare ecosystem that ensures affordable, inclusive, and high-quality healthcare for all. The launch of Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), the largest public health insurance programme, is a pathbreaking initiative in this direction designed to cater to the healthcare needs of economically disadvantaged sections of the population. The present study aims at understanding awareness levels and knowledge of the features of the Ayushman Bharat scheme among the beneficiaries in select towns of three districts of Telangana in terms of their access to hospital-care services under this scheme. Out of 33 districts in Telangana State, there are a maximum number of Ayushman cardholders in the District of Hyderabad (6.48 lakhs), Rangareddy (6.54 lakhs) followed by Medchal (2.89 lakhs). A survey of 500 households from the select towns of these three districts is being undertaken, and it revealed many gaps in knowledge and awareness of the features of the scheme among the beneficiaries. From the study, it was observed that (a) incomplete information on the scheme, (b) poor infrastructural support, (c) insufficient human resources, (d) lack of awareness on the extent of insurance coverage, and (e) ineffective grievance handling systems were considered to be the major factors that prevented the beneficiaries from availing the intended benefit from the scheme.