PRESS NEWS
Ministry
of Health and Family Welfare
Explainer on Ayushman Bharat
Health Accounts (ABHA)
Posted
On: 04 APR 2024 12:28PM by PIB Delhi
Ayushman Bharat
Health Accounts (ABHA) is an integral component of the Ayushman Bharat Pradhan
Mantri Jan Arogya Yojana (AB-PMJAY), which is India's flagship national health
protection scheme. ABHA is designed to facilitate cashless transactions and
manage financial aspects related to healthcare services under the Ayushman
Bharat scheme. Here's an explainer on Ayushman Bharat Health Accounts:
- Introduction:
Ayushman Bharat Health
Account (ABHA) is an account/ number used to link all the health records of a
person. ABHA intends to create a digital health ecosystem & aims to promote
digitization of healthcare. Any individual can enroll in Ayushman Bharat
Digital Mission (ABDM) to generate a Health ID or ABHA, free of cost.
2. Objective:
Ayushman Bharat Health Accounts aim to provide a seamless and
efficient financial framework for implementing the Ayushman Bharat scheme. It
ensures transparency, accountability, and accessibility of funds allocated for
healthcare services.
3. Features:
Cashless
Transactions: ABHA enables cashless transactions for eligible beneficiaries
seeking treatment at empanelled healthcare facilities. This reduces the
financial burden on beneficiaries during medical emergencies.
Electronic
Health Records (EHR): ABHA integrates electronic health records, facilitating the
storage and retrieval of patient information. This helps in maintaining medical
histories and streamlining healthcare delivery.
Portability: The accounts are designed to be portable across various
healthcare providers empanelled under the Ayushman Bharat scheme, allowing
beneficiaries to access services seamlessly, regardless of their location.
Real-time
Monitoring: ABHA incorporates real-time monitoring mechanisms to track the
utilization of funds and ensure that resources are allocated efficiently. This
helps in preventing misuse and optimizing the distribution of healthcare
resources.
Transparency
and Accountability: By promoting digital transactions and maintaining electronic
records, ABHA enhances transparency and accountability in the healthcare
system. This reduces the scope for corruption and ensures that funds are
utilized for their intended purpose.
4. Components:
Beneficiary Identification: ABHA involves
the identification and registration of eligible beneficiaries under the
Ayushman Bharat scheme. Each beneficiary is assigned a unique health
identification number (UHID) to facilitate tracking and management.
Funds Management: ABHA manages the allocation and disbursement of funds for
healthcare services availed by beneficiaries. It ensures that funds are
transferred to healthcare providers promptly and securely.
Claim Settlement: ABHA processes and settles claims submitted by healthcare
providers for services rendered to beneficiaries. This involves verifying the
authenticity of claims and disbursing payments accordingly.
Audit and Oversight: ABHA incorporates audit and oversight mechanisms to monitor the
utilization of funds and detect any irregularities or discrepancies. This helps
in ensuring compliance with regulations and maintaining the integrity of the
healthcare system.
5. Benefits:
Financial Protection: ABHA
provides financial protection to vulnerable sections of society by covering the
costs of healthcare services under the Ayushman Bharat scheme. This reduces
out-of-pocket expenses for beneficiaries and enhances access to quality
healthcare.
Efficient Healthcare Delivery: By facilitating cashless transactions and electronic
health records, AB-HA promotes efficiency in healthcare delivery. It minimizes
administrative hassles and delays, allowing healthcare providers to focus on
patient care.
Data-driven Decision Making: ABHA
generates valuable data insights that can be used for evidence-based
decision-making and policy formulation. This helps in addressing healthcare
challenges effectively and improving the overall quality of care.
An ABHA user has the following identifiers and user app to
access the benefits under ABDM:
ABHA number: Unique Health Identifier as a random 14-digit number: A unique
identity of a person, across different health care providers across the
country.
ABHA address: ABHA Address is
an easy-to-remember username that enables a user to access their health records
digitally and share their records with various healthcare providers. An ABHA
address may look like ‘name@abdm’. It may also be required to sign up on ABHA
mobile Application.
ABHA mobile
application: The ABHA mobile application offers a convenient solution for
individuals to effortlessly access and share their health records digitally. It
empowers patients to seamlessly receive digital lab reports, prescriptions, and
diagnoses from various healthcare providers, including doctors, labs,
hospitals, and wellness centers. This approach ensures secure and
consent-driven sharing of health data.
6. Benefits for
CGHS Employees:
·
ABHA
shall integrate CGHS beneficiaries in the digital health ecosystem for the
country.
·
A
CGHS beneficiary shall be able to view the generated and linked health records
in any of his/her preferred Personal Health Record (PHR) app downloaded on the
mobile device.
·
A
CGHS beneficiary shall be able to carry forward his/her health records from one
hospital/Healthcare provider to another in a digitally secured way.
·
e.g:
Take the case of health records generated in a particular hospital for a
particular patient by a particular doctor. The said patient may end up going to
some other healthcare provider for subsequent treatment. It is desirable that
his/her health records which are stored in the previous hospital are also
available to the subsequent healthcare provider for comprehensive healthcare
provision. This is made possible by unique entity (Health ID) which identifies
the patient’s health records across all the healthcare providers. With the
patient’s consent, these records are made available to the current healthcare
provider.
·
In
future, a CGHS beneficiary shall directly be able take OPD appointment of a
Doctor just by scanning a QR code through his/her mobile device present in
front of the Doctor’s room/ Registration Desk in the Wellness Centre.
7. Steps to
Create/Link ABHA number with the CGHS beneficiary ID:
Pre-Requisites:
Ensure that the mobile number is linked with the CGHS card.
Ensure that the Aadhar card is linked with the aforementioned
phone number.
Step 01: Open CGHS website www.cghs.nic.in and Log-in via
Beneficiary Log-in
Step 02: Move to the ‘Update’ Tab and Click ‘Create/Link ABHA ID’
Step 03: In front of the “Beneficiary Name” An option shall be
visible ‘Create/Link ABHA ID’. Click on that option.
Step 04: In case a beneficiary does not have an ABHA number, click
on ‘I don’t have an ABHA number’
Enter Aadhar number
Accept the Consent Message
Click on Get Aadhar OTP
Enter Aadhar OTP
Click on ‘Verify OTP’
If the data is successfully matched, the ABHA number is created
and successfully linked with the CGHS beneficiary ID.
*In case a beneficiary already has an ABHA number, In step 04,
instead of clicking on ‘I don’t have an ABHA number’, enter the 14 digit ABHA
number and proceed by verifying OTP.
For more information, visit: https://abha.abdm.gov.in/abha/v3/
A detailed video on the step-by-step procedure to Create/Link
ABHA number is also available on the ‘@cghsindia’ YouTube channel at the
following link:
https://www.youtube.com/watch?v=ZVytyQv2ngo&t=90s
8. Future Directions:
Expansion and
Enhancement: ABHA is expected to evolve and expand over time, incorporating
new features and functionalities to meet the evolving needs of the healthcare
sector.
Integration
with other Schemes: There is
potential to integrate ABHA with other healthcare schemes and initiatives to
create a unified and comprehensive healthcare ecosystem.
Research and
Innovation: Continued
research and innovation in healthcare financing and delivery models can further
strengthen the effectiveness and impact of ABHA.
In conclusion, Ayushman
Bharat Health Accounts play a pivotal role in facilitating cashless
transactions, managing funds, and enhancing transparency in the implementation
of the Ayushman Bharat scheme. By leveraging technology and data-driven
approaches, ABHA aims to improve access to quality healthcare and alleviate the
financial burden on vulnerable sections of society.
MYTH VERSUS
REALITY:
Myth 1: Does getting ABHA Number mean enrolment in Ayushman Bharat –
Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)?
Reality: No,
ABHA is just an account/ number used to link all the health records of a
person.
Myth 2: What
is not entailed under Ayushman Bharat Health Account?
Reality: Ayushman Bharat Health Account does not mean the eligibility of
a person for the particular scheme including AB-PMJAY. Ayushman Bharat Health
Account is not a replacement of current CGHS services or a replacement of
current CGHS HMIS. Rather it is an addition/add-on to the current services
offered by CGHS.
Myth 3: I
am afraid that by linking all my health records to my ABHA other doctors may be
in a position to see all my medical History which I don’t want to show. How can
this be prevented?
Reality: The consent provided digitally need not be for all the
health records linked to ABHA at a time. It can be provided for sharing only
selected health records as per the choice of the patient. Therefore, by linking
all your health records to your ABHA you will not end up sharing all your
health records when providing consent. The consent is granular “which can be
provided separately for each of the health records as per the wish of the
patient”. However, it is recommended that you provide consent to share all
health records with your doctor so that he can make correct clinical decisions.
Myth 4: Is
it possible for the government or any other entity to do surveillance of the
health status of an individual through ABDM?
Reality: No. The health records are created and stored at the place of
their creation by respective healthcare providers (which is the case even now).
ABDM is creating interoperable platforms for linking these data
repositories/fiduciaries. This is known as federated architecture. This means
that the health records will continue to be processed and stored at the same
place where they are created, which has been happening prior to ABDM as well.
The government will not have access to such data. No additional means of
accessing such data is being created or envisaged in the current ecosystem.
Myth 5 : Will
my Digital health Records be shared with other doctors or health facility
without my permission?
Reality: No. Only you can share your own records with other
doctors/hospitals using different digital health systems after giving your
consent.
Myth 6: How
will my data be used by the government?
Reality: Protocols for anonymization and aggregation of data and use of
such data will be defined after extensive stakeholder consultations. After
that, anonymous records can be used by the government to make policies and
other relevant interventions in the interests of the public. Till this is done,
health records will not be used by the government.
Myth 7: Are
my health records safe and Secure on ABDM System?
Reality: ABDM does not store any medical records. These
are always created and stored by healthcare providers as per their retention
policies and this will continue. ABDM only facilitates secure data exchange
between the intended stakeholders on ABDM network after the patient’s consent.
Hence, through ABDM compliant applications, patients will also be able to
choose which health records they want to link with their Health IDs, securely
store their digital health records on their devices, securely access their
records online, and securely share their health records with healthcare
providers after the patient’s consent. Only the data collected for registries
such as Health ID registry, Healthcare Professional Registry and Healthcare
Facility Registry is stored centrally. It is necessary for these datasets to be
stored centrally because they are essential to provide interoperability, trust,
and identification and single source of truth across different digital health
systems. This data is stored and processed in secure and safe manner.
Myth 8: Can ABHA be used
outside the government hospital/CGHS?
Reality: Yes, ABHA can be used outside the government hospital/ program.
However, it is up to the private players to decide whether they want to use it
or not. For example, a private hospital may decide to use ABHA for creation and
linking of health record. If the patient is not willing to use ABHA, the
hospital/ program may provide an alternate number which they are using as part
of their existing system. MV HFW/ABHA Explainer/4thApril2024/1(Release
ID: 2017129)
