The Director General of Health Services under the health ministry has proposed to bring down the cost of angioplasty procedure to open blocked arteries by 40% — from Rs. 85,000 to Rs. 55,000 — in its Central Government Health Scheme (CGHS) empanelled hospitals.
This means hospitals will now be paid the revised amount for doing the procedure on CGHS beneficiaries.
However, private hospitals say it's impossible to provide services even at the existing cost. Escorts Heart Institute (FEHI), which does the highest number of angioplasties in India, had already pulled out of CGHS in late October saying they could not do an angioplasty at the existing rate of R85,000.
Private hospitals charge non-CGHS beneficiaries between R90,000 and R1, 50,000 for the procedure plus the cost of the stent (varies from R20,000- R3 lakh), while government hospitals do it for Rs. 60,000- Rs. 80,000, plus the cost of stent.
“We came off the CGHS panel in October as the deductions in the angioplasty procedure were not a viable option. The payments were not matching the quality of services, the expertise and equipment we provide. Now, there is talk of further reduction to R55,000, which is ridiculous,” said Dr Ashok Seth, chairman, cardiac services at FEHI.
“We did not want our CGHS patients to suffer. It is natural if the hospital was being paid so poorly by the government for a procedure, this reduction will have a direct impact on patient services and this is not fair,” he said.
“It is impossible for any heart hospital to sustain at such low reimbursement rates for angioplasty,” said Dr Purushottam Lal, chief, Metro Heart Institute.
“Ultimately, quality of treatment will suffer. I am not against the reduction, but reducing R85,000 to R55,000 will see private hospitals coming out of the CGHS pact. A discussion should be held by the ministry with the stent industry, government bodies and private hospitals, so that none of the stakeholders, including the patients, suffer,” he said.
But Director General of Health Services Jagdish Prasad feels that this decision will go a long way in regulating the cost of heart procedures.
“This decision to reduce prices should come through by the end of this week. Since there was no correction in so many years, the prices of heart procedures went beyond the reach of the common man,” said Dr Jagdish Prasad.