AB PM-JAY To Adopt Integrated Framework Offering End-To-End Healthcare
Over 40.45 crore Ayushman cards have been issued, covering 14.69 crore families till March this year
Published : October 16, 2025 at 7:10 PM IST
New Delhi: The Union Health Ministry may expand the scope of the world’s largest government-funded health insurance scheme-Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), through an integrated framework that ensures continuum of care approach and enable strong referral linkages across primary, secondary and tertiary levels of healthcare.
A future road map of AB PM-JAY as released by the National Health Authority (NHA) on Thursday, said, "The Ayushman Bharat network will be expanded to deliver services across the full continuum of care, supported by an effective referral system that connects primary, secondary, and tertiary facilities. This integrated approach, as envisaged in the National Health Policy, will enhance access, efficiency, and resilience in the healthcare ecosystem."
The NHA is the apex body responsible for implementing India’s flagship health insurance scheme, AB PM-JAY. The AB PM-JAY has completed seven years of implementation, and is poised at a point where building on past achievements and harnessing innovations is crucial to pave the way for the future.
The scheme aims to provide financial protection against catastrophic health expenditure by offering health coverage of up to Rs five lakhs per family annually for secondary and tertiary care hospitalisation, targeting the bottom 40 per cent of the country's population.
"To ensure the sustained and effective implementation of the scheme, a set of strategic interventions are proposed, to enhance coverage, service delivery, accountability, and system efficiency," the NHA report for 2024-25 said.
Over 9.19 crore hospital admissions have been facilitated under AB PM-JAY with treatment worth Rs 1,29,386 crores since the project was initiated. NHA has issued over 40.45 crore Ayushman cards covering 14.69 crore families till March this year. Of the 31,005 hospitals that are empanelled under the scheme, 55 per cent are public healthcare facilities.
According to the report, achieving 100 per cent saturation of Ayushman cards across all implementing states and Union Territories continues to be a key priority. "Targeted efforts will be undertaken to identify and enroll all eligible beneficiaries, particularly in remote and underserved areas, to ensure equitable access to healthcare benefits under the scheme," the report stated.
Stating that seamless, user-friendly, and efficient IT infrastructure is the backbone of AB PM-JAY, the report said that continuous upgrades and optimisation of core digital platforms, such as the BIS, TMS, HEM, and CGRMS will be undertaken to improve accessibility and operational efficiency for all stakeholders.
"Institutionalising anti-fraud framework is key to preserving the integrity of the scheme and building trust. Going forward, predictive analytics, real-time monitoring, and automated checks to proactively detect, deter, and address suspicious activities and fraudulent claims will be further strengthened," the report added.
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