What stops private hospitals from engaging with publicly funded health insurance schemes? A mixed-methods study on PMJAY/MJPJAY in Maharashtra, India.

ABSTRACT:

Background

Reducing patient expenditure and expanding healthcare access through private sector hospitals is widely touted strategy for governments to achieve Universal Health Care, including in India. However, private sector engagement in India's publicly funded health insurance schemes (PFHIS) remains low and is uneven across geographies and by hospitals size. This paper examines challenges to achieving effective private sector engagement in PFHIS by analysing private sector participation and exploring diverse stakeholder perspectives.

Methods

This case study used sequential mixed methods design and was conducted in 2023-24 in Maharashtra, India. We combined quantitative analysis of the geographic distribution of empanelled private hospitals (993 across Maharashtra's 36 dis

SUBMITTER: Marathe S 

PROVIDER: S-EPMC11912764 | biostudies-literature | 2025 Mar

REPOSITORIES: biostudies-literature