DECCAN SCHOOL OF MANAGEMENT

(Affiliated to Osmania University by AICTE Ministry of HRD, New—Kanchan Bagh,

Santosh Nagar, Hyderabad)
DISSERTATION ON
TOPIC- A STUDY ON AAROGYASRI PATIENTS AND SCHEME
Submitted to
DECCAN SCHOOL OF MANAGEMENT
OSMANIA UNIVERSITY, HNYDERABAD.
SUBMITTED BY
NAME: MOHAMMED ATEEB ALI
ROLL NO. 32

FOR,

Project submitted in partial fulfilment of award of

MASTER’S DEGREE IN HOSPITAL MANAGEMENT
2023-2025
 DECLARATION
I Here declare that the project titled ‘A STUDY ON
AAROGYASRI SCHEME AND PATIENTS’ ” at Owaisi
Hospital is a genuine work carried out by me under the
guidance of Dr. Manisha Saxena, this has not been submitted in
past or whole for the award of either degree or diploma of any
university or sent for awareness for publication elsewhere.

Name of the student: Mohammed Ateeb Ali

Signature of the student:
Abstract
Aarogyasri scheme is a health insurance program granted collectively by
Telangana and Andhra Pradesh state governments for their citizenry. It assists poor
sections of the society get free treatment for serious illnesses that impact life in a
significantly negative way. The government assumes the entire expenditure for
curative procedures. This scheme is applicable in both private and government
administered hospitals. Patients get a health card which allows them to avail
medical services under the Aarogyasri scheme. Most people under this scheme are
those that possess a BPL card (Below Poverty Line) or a white ration card. The
execution of Aarogyasri scheme that benefit the patients and maintains or regulates
the health standards of target populations and it ultimately contributes towards
quality of life and a good image of the nation on world stage. This dissertation
investigates the scheme’s impact on patient health outcomes, challenges patient s
face in availing services and measure patient satisfaction. The scheme is a step
towards revolutionizing healthcare delivery. It is an initiative that promotes free
treatment (for high-end surgeries and major treatments for severe and rare
diseases) where beneficiaries (patients in this context) receive cashless treatment. It
also supports health camps and similar activities engaging public to screen and
detect diseases early, making the timely treatment efficient. The medical personnel
in Aarogyasri areas of jurisdiction is called as Aarogyamithras.
Acknowledgement
The project coming to such a successful fruition cannot be attributed to me alone. I
extend my genuine gratitude to my professors – especially my supervisor Sir Afroz
Sikander who has helped me throughout since the selection of this topics and to
refining some of the contents and giving a final approval. The next portions of
thanks goes to my faculty members – namely, Akbar sir, Zeba ma’am, Sumaiyya
ma’am and Dr. Manisha Saxena who have nurtured me throughout this
enlightening Master’s degree program that broadened the way I deal with varying
situations in administration. Having exercised my academic capabilities for this
research endeavor I gained educational inputs in various aspects of life. That is, the
experience transcends the managerial or administrative methods. The dual benefit
of the project lies in two areas – scholarship and personal growth. Critical thinking
skills were in a situation to adapt to the prevailing conditions in order to result a
solution to existing problems and their dynamics. Furthermore, the dissertation
highlights healthcare practices (preemptive and curative), methods of availing
services without operational hiccups and how the scheme is a national level
exemplar for providing free services that act as solace for despairing populations.
Table of Contents
 Table of contents
S. no CONTENTS
1 Introduction
2 Inclusivity, Challenges & Roadblocks
3 Objectives
4 Literature Review
5 Organizational Profile
6 Evolution of Aarogyasri Scheme
7 Data Analysis and Inferences
8 Study Limitations & Further Scope
9 Conclusion

Introduction
In 2007, the Government of Andhra Pradesh launched the Aarogyasri scheme to
cater for the BPL (Below Poverty Line) and similar target population. The scheme
came out as a result of lack of access to medical treatments especially for poorer
sections of society battling with severe illnesses. It emerged during a period where
there was a growing public demand. Prior to its implementation, situation was
relatively much backward such that people experienced financial ruin. Thus the
aim was to create a sustainable facility that provides free, cashless treatment for
BPL families. In simple terms, the scheme is designed to provide free medical
treatment to families living below the poverty line (BPL). This means that if
someone in these families falls seriously ill, they can receive treatment without
having to pay for it. It covers for major surgeries and treatments. This had a
domino effect on the nation resulting into the issuance of similar schemes (such as
Ayushman Bharat Health Account) at central level.

What is Aarogyasri Scheme?

The Aarogyasri scheme stands as a monumental initiative in the Indian healthcare
landscape. It is a health insurance program that covers a wide range of medical
treatments. It includes surgeries, hospital stays, and specialized care for various
diseases. The goal is to ensure that financial constraints do not prevent individuals
from accessing necessary healthcare. Launched with the vision of "Health for All,"
The scheme covers a wide range of medical conditions, including heart diseases,
cancer, neurological disorders, and pediatric congenital malformations. Notably, it
also includes high-end procedures such as organ transplants and cochlear implants
for children under 2 years of age. The scheme provides coverage up to ₹10 lakh
per family per annum, ensuring that even high-cost treatments are accessible
without financial constraints. This coverage is applicable across a network of 1,042
government and 368 private empaneled hospitals throughout the state, facilitating
timely and effective healthcare delivery. Its cashless transaction model is a novel
feature in healthcare that allows availing services without any upfront payments.
The scheme is managed by the Aarogyasri Health Care Trust, which oversees the
implementation and monitoring of the program.
The government directly settles the bills with the empaneled hospitals, ensuring
that financial barriers do not hinder access to necessary treatments. This model has
been instrumental in providing timely medical interventions to those in need.

Technological Innovations
The Aarogyasri scheme has incorporated information and communication
technology (ICT) to streamline operations:
Digital Platforms: The introduction of mobile applications and online portals has
facilitated the issuance of Aarogyasri cards, status checks, and hospital
empanelment processes. These digital tools have improved transparency and
accessibility for beneficiaries.
Data Management: The use of centralized databases has enabled efficient
tracking of treatments, reimbursements, and beneficiary information. This has
enhanced the accountability and monitoring of the scheme's implementation

Inclusion of Vulnerable Groups

Recognizing the healthcare needs of vulnerable populations, the Telangana
government has extended the benefits of the Aarogyasri Scheme to orphaned and
differently-abled children residing in Child Care Institutions (CCIs). Through the
"Orphan Health Card" initiative, these children receive medical coverage for over
1,800 procedures, ensuring they have access to essential healthcare services that
were previously inaccessible due to financial constraints. A significant aspect of
this initiative is its inclusivity, ensuring that even the most vulnerable populations
receive necessary medical care.
Recognizing the unique healthcare needs of orphaned and differently-abled
children, the Telangana government has extended the benefits of the Aarogyasri
Scheme to these groups. Through the "Orphan Health Card" initiative, children
residing in Child Care Institutions (CCIs) are now eligible for medical treatments
covered under the scheme. This move addresses the financial barriers that
previously hindered these children from accessing essential healthcare services. As
of the latest reports, over 2,200 children in CCIs have benefited from this
inclusion, receiving treatments ranging from routine check-ups to complex
surgeries.
Additionally, the introduction of the "orphan card" category in the Aarogyasri
registration portal has streamlined the process, linking each child's Aadhaar card to
facilitate easy access to services. he inclusivity of the Aarogyasri Scheme has had a
profound impact on the health outcomes of vulnerable populations. Children who
were once deprived of timely medical interventions due to financial limitations are
now receiving necessary treatments, leading to improved health and quality of life.
Caretakers have reported significant improvements in the children's health, with
many undergoing life-saving surgeries and receiving ongoing medical care that
was previously inaccessible.

Upcoming Foreseeable Prospects

The government plans to extend the benefits of the Aarogyasri Scheme to all
10,000 children residing in CCIs across the state. This expansion aims to ensure
that every child, regardless of their background or circumstances, has access to the
healthcare they need. This signifies a precedent a precedent for equitable
healthcare access for all citizens.
Increased Budget Allocation: Proportional increase in budget to match the rising
number of beneficiaries and inflationary costs.
Timely Payments: Streamlining payment processes to ensure timely
reimbursements to empanelled hospitals
Monitoring and Evaluation: Regular assessment of the scheme's performance to
identify areas of improvement and ensure accountability.
Infrastructure Development: Investing in healthcare infrastructure to meet the
growing demand for services and improve the quality of care.

There are drawbacks surrounding this scheme. One major problem is: many
eligible beneficiaries face difficulties in enjoying all the services. And testing or
measuring the outcomes of the scheme are very hard to determine the levels of
patient satisfaction and if the operational outcomes align with the overall mission
and vision of the hospital.

Challenges and Considerations:

While the Aarogyasri Scheme has made significant strides in improving healthcare
access, certain challenges persist. The primary focus of the scheme is on inpatient
services, with limited coverage for outpatient consultations and medications.
Additionally, disparities in healthcare infrastructure between urban and rural areas
can affect the quality and accessibility of services.
Furthermore, the implementation of the scheme requires effective coordination
between various stakeholders, including government agencies, healthcare
providers, and beneficiaries. Addressing these challenges is crucial for maximizing
the effectiveness of the scheme and ensuring equitable healthcare for all.
Studying Aarogyasri scheme is important because it is intrinsically linked to health
and welfare especially of poorer sections of the society. Moreover, there is lack of
understanding of the finer details of how the scheme works which reduces clarity
of procedures to be followed and it acts as hindrance from availing the service. A
pressing need for administrators dealing closely with the scheme is to know if the
scheme is viable in reducing financial barriers of poor citizens, measure patient
contentment, barriers preventing people to avail service, areas of improvement.
Cognizance of all aforementioned variables must be synchronized with all
policymakers, healthcare workers and administrators.

Elaboration on Roadblocks
Supplier-induced demand (SID) occurs when a supplier, such as a physician or
healthcare provider, influences a patient's demand for services beyond what is
medically necessary. This often arises due to information asymmetry, where the
supplier possesses more knowledge about treatment options than the patient.
Consequently, the supplier may recommend additional tests, procedures, or
treatments to increase their income, leading to overutilization of services. In
healthcare, SID can result in unnecessary procedures, increased healthcare costs,
and inefficiencies in resource allocation. Addressing SID involves promoting
transparency, evidence-based practices, and aligning provider incentives with
patient well-being.
The scheme's design, which reimburses hospitals per treatment, has led to concerns
about supplier-induced demand, where hospitals may over-provide treatments to
maximize reimbursements. Studies suggest that engaging insurance intermediaries
may not effectively address this issue and could reduce fund flow to government
hospitals.

Awareness and Accessibility

Accessibility refers to the extent to which a product, service, or environment is
designed to be available and usable by as many people as possible, including those
with disabilities or special needs. It involves removing barriers to ensure that all
individuals, regardless of their abilities, can participate fully in organizational
activities.
A study conducted in Chittoor district revealed that while 86.53% of families were
covered under the scheme, only 6.77% utilized the benefits in the past year.
Barriers such as lack of awareness, absence of Aarogyasri cards, and procedural
complexities hindered access to healthcare services.
Financial Sustainability: Private hospitals have occasionally halted services
under the scheme due to delayed reimbursements. In Andhra Pradesh, a backlog of
over ₹3,000 crore in dues has led to disruptions in services, with hospitals ceasing
outpatient treatments and threatening to stop emergency services if payments are
not cleared.
Supplier-Induced Demand: The scheme's design, which reimburses hospitals per
treatment, has led to concerns about supplier-induced demand, where hospitals
may over-provide treatments to maximize reimbursements. Studies suggest that
engaging insurance intermediaries may not effectively address this issue and could
reduce fund flow to government hospitals.
Infrastructure Limitations: The focus of the scheme on secondary and tertiary
care often led to the neglect of primary healthcare services. The absence of
adequate infrastructure and medical personnel in rural areas further exacerbated the
problem, leaving many beneficiaries without timely medical attention

Objectives:
1. Evaluating impact of Aarogyasri scheme
2. Spot challenges patients face in availing services
3. Assessing the capacity to determine patient satisfaction
In order to solve the research problem, the first operation is to find present
standing, assess resources, make a viable and realistic goal (and time to achieve it).
The end-goal can be reached via many routes (hypotheses).
The following is a list of applicable/relevant hypotheses:
Hypothesis for Objective 1 (Evaluating Impact of the Scheme):
i. The Aarogyasri scheme has diminished healthcare expenses for BPL
citizenry. This allows economy to grow and cash-in-hand to foster.
ii. Patients recovering via Aayogasri scheme show better recovery, even for
critical illnesses.
iii. Since the scheme got enacted, usage of tertiary healthcare services in
government has increased. Resulting in proper cycle flow of money
between governments, citizens and cash inflow.
Hypothesis for Objective 2 (Identifying Challenges in Availing Services):
i. Limited awareness leads to underutilization and/or reduction of availing
service, as the finding indicates.
ii. Procedural delays and formalities waste a lot of time making timely
treatment very hard or practically impossible.
iii. Populations from rural areas face more barriers (logistics, travel, cost). A
lot of people barred from availing the scheme’s service fall under rural
areas.

Hypothesis for Objective 3 (Assessing the capacity to determine patient

satisfaction)
i. In most cases, it is impractical to even attempt to extract or encapsulate
significant and objective data from subjective feedback procedures. Thus,
it is concluded that determining patient satisfaction requires a much more
nuanced approach: manual feedback integrated with statistical tools.

Literature Review
The Aarogyasri Scheme initiated by Andhra Pradesh government and later retained
by Telangana is a very fruitful move for social welfare. Extensive discussions
regarding the scheme continue as a significant progress-making step towards
health coverage for poor in India.
Among various studies conducted, Rao et al. 2013 and Berman et al. 2010 indicate
strongly that Aarogyasri has significantly improved access to specialized health
services to those that cannot afford. Self-reliant funding for one’s health has
significantly and consistently dropped since the scheme initiated (Mukhopadhyay
& Panigrahi, 2017).
Like any business endeavor, the implementation of Aarogyasri scheme – an
integration of managerial methods and delivery of health care – is faced with
operational challenges that are induced in on-ground routines. Studies by Barik and
Thorat (2015) suggest that institutional inefficiencies and non-uniform distribution
of empaneled hospitals affect the accessibility of scheme.
A study conducted by the Centre for Health Market Innovations (2016) points out
that private hospitals are more dominant than government hospitals in terms of
applying the scheme to its patients. But due to the asymmetric non-uniform
distribution of private hospitals, it geographically restricts ease of availing scheme
benefits.
Mishra et al. (2018) posits that although customers are relatively content with
cashless service, factors such as infrastructure, waiting time, communicating with
medical personal (for diagnosis, clarification regarding prescriptions or general
illnesses), post treatment support are also strong indicators of a patient’s level of
satisfaction.

Studies by NSHRC (National Health Systems Resource Centre) that hospitals in

certain areas are poorly regulated and of poor quality. This results in poor impact.
Maintaining financial stability whilst executing the scheme is challenging as
concluded by Rajasekhar et al. (2019).

Methodological Clues from the Literature Review:

1. Mixed-Methods Approach: Many of the above mentioned conclusions –
such as Rao & Mishra concluded their findings via an integrated approach of
quantitative and qualitative methods. Evaluating numerical outcomes
(medical expenses) and subjective experiences must go hand in hand.
 2. Use of Beneficiaries Surveys: Research carried out by Panigrahi (2017) used
holistic questionnaires to get systemized patient feedback. Here,
questionnaires are a survey tool within research methodology to measure
patient satisfaction.
3. Key Informant Interviews: Concerned personnel (administrators, scheme
officials, Aarogyamithras) conduct interviews which were later used by
Devadasan et al. (2012) and Barik & Thorat (2015) to overcome institutional
challenges. This semi-structured interview utilizes predefined questions
allowing for in-depth responses characterized by a conversational tone. An
efficient tool in research.
4. Stratified Sampling Techniques: For collecting data from a diverse
heterogeneous population, stratified sampling has high utility. It helps
stratify based on creating sub groups (such as age, gender, location) that are
more accurate in representing the whole. It makes generalizing easy.
5. Field Observations: Direct on-ground observations (aka field observations),
careful analysis of first-hand patient stories of medical history (case study).
And making notes that act as content of research and provide inputs for later
researches. Combining the data of field notes and medical histories allows
deeper understanding of problems or bottlenecks to solve. An example of
this is: Reddy et al. (2012)
6. Use of Medical Records: In compliance with legal codes, hospitals maintain
patient records (pertaining to admission, pre-authorization or
permission/consent before treatment and reimbursement records).
Examining this type of secondary data helps spot trends of healthcare usage.
7. Thematic Analysis: A tool used when conducting intakes of qualitative data.
It involves looking at common themes or constantly reiterated ideas in what
people said. It allows noting patterns in what patients undergo and how
hospital systems work.

Challenges and Criticisms:

Sustainability Concerns: The financial viability of the scheme was questioned
due to the high costs associated with providing free medical services.
Quality of Care: There were concerns about the quality of services provided,
particularly in private empanelled hospitals, where the focus on volume could
compromise care standards.
Awareness and Accessibility: Many eligible beneficiaries were unaware of the
scheme or faced difficulties in accessing services due to logistical issues.

Organization

Owaisi Hospital and Research Centre was established in 1996. And since the inception of
the Aarogyasri scheme, OHRC has implemented it with integrity and compliance. OHRC
has fulfilled all its obligations to provide solace. Its target population has mostly been BPL
citizens and Muslims in Old City that cannot afford extensive treatments. It has many key
notable achievements. The hospital has honoured the trust it receives from target
populations. It has become a source of hope for cure from ailments. Since its start,
Aarogyasri evolved from covering. 700000 families to over 2 crore patients since the
separation of Telangana from Andhra Pradesh. Upgradations in infrastructure, skilled
personnel has been in proportion to trends in the overall market indicating competency to
meet growing demands. The services OHRC providies is not restricted to healthcare
delivery. It also provides degrees on medical professions. It is combined with the Deccan
College of Medica Sciences. Throughout time, it has increased its capacity to host 1050
beds in departments like cardiology, nephrology, neurology and other departments. OHRC
fosters constant efforts to produce quality research. To conclude, OHRC plays a very vital
role in public health equity in Telangana.

Evolution of Aarogyasri
The scheme was re-named to Dr. YSR Aarogyasri Health Insurance Scheme. After
the bifurcation of Telangana, the new government introduced new version of this
scheme known as Rajiv Aarogyasri with similar objectives. Its inception can be
traced back to the visionary leadership of Dr. Y.S. Rajasekhara Reddy, the then
Chief Minister of Andhra Pradesh.
Before the advent of Aarogyasri, the healthcare system in Andhra Pradesh faced
significant challenges, particularly in catering to the needs of the Below Poverty
Line (BPL) families. High out-of-pocket expenses for medical treatments often led
to families falling deeper into poverty. The existing public health infrastructure
was inadequate, and private healthcare services were largely inaccessible to the
economically disadvantaged.
Dr. YSR, a medical doctor by training, recognized these disparities and was deeply
moved by the plight of the poor who were unable to afford necessary medical
treatments. This empathy drove him to conceptualize a healthcare model that
would bridge these gaps and ensure that quality medical services were within reach
of every citizen, irrespective of their economic status.
The scheme was initially implemented in select districts and was later expanded
statewide due to its success and positive reception among the public.
Both states established dedicated agencies—the Aarogyasri Health Care Trust in
Andhra Pradesh and the Aarogyasri Health Care Trust in Telangana—to oversee
the implementation and management of the scheme. These agencies are
responsible for empaneling hospitals, setting treatment protocols, and ensuring the
smooth operation of the scheme.
In Telangana, the coverage has been extended to ₹10 lakh per family per annum,
encompassing 1,672 treatments across 21 specialties. Approximately 90.1 lakh
BPL families benefit from this scheme, with all transactions being cashless,
ensuring that beneficiaries do not incur out-of-pocket expenses for covered
procedures.
In Andhra Pradesh, the scheme initially covered 2,434 medical procedures. Over
time, this number has increased, with the government expanding the list of covered
treatments and enhancing the financial assistance provided to beneficiaries. For
instance, patients undergoing treatments for conditions like thalassemia, sickle cell
anemia, and hemophilia receive a monthly financial assistance of ₹10,000 .

Statewide Implementation: The scheme was extended to all districts in Andhra

Pradesh, ensuring that a larger population could benefit from its services.
Increased Coverage: The number of medical procedures covered under the
scheme was expanded, incorporating more treatments to address a broader
spectrum of health issues.
Technological Integration: Digital platforms were introduced to streamline the
registration process, track treatments, and facilitate communication between
beneficiaries and healthcare providers.
These enhancements aimed to improve the efficiency and reach of the scheme,
ensuring that it continued to meet the evolving healthcare needs of the population.
 Data Analysis and Inferences
Owaisi Hospital and Research Centre was established in 1996. And since the
inception of the Aarogyasri scheme, OHRC has implemented it with integrity and
compliance. OHRC has fulfilled all its obligations to provide solace. Its target
population has mostly been BPL citizens and Muslims in Old City that cannot
afford extensive treatments. It has many key notable achievements. The hospital
has honoured the trust it receives from target populations. It has become a source
of hope for cure from ailments. Since its start, Aarogyasri evolved from covering.
700000 families to over 2 crore patients since the separation of Telangana from
Andhra Pradesh. Upgradations in infrastructure, skilled personnel has been in
proportion to trends in the overall market indicating competency to meet growing
demands. The services OHRC providies is not restricted to healthcare delivery. It
also provides degrees on medical professions. It is combined with the Deccan
College of Medica Sciences. Throughout time, it has increased its capacity to host
1050 beds in departments like cardiology, nephrology, neurology and other
departments. OHRC fosters constant efforts to produce quality research. To
conclude, OHRC plays a very vital role in public health equity in Telangana.
Recommendations for Improvement:
Awareness Campaigns: Intensive information, education, and communication
(IEC) activities are essential to inform beneficiaries about the scheme's benefits
and procedures. Systematic and collectively done efforts must take place to expand
the services and benefit citizenry. It also comes under a sort of marketing move.
Strengthening Primary Healthcare: Investing in primary health centers and
wellness centers can ensure that basic healthcare services are accessible within
close proximity to communities.
Timely Reimbursements: Addressing the issue of delayed payments to hospitals
can prevent disruptions in services and maintain the trust of healthcare providers.
Monitoring and Evaluation: Regular assessments and audits can help identify
gaps in service delivery and areas for improvement, ensuring that the scheme
meets its objectives effectively.

When compared to other health insurance schemes like Ayushman Bharat,

Aarogyasri offers a more extensive coverage in certain areas. For instance, in
Telangana, the coverage under Aarogyasri has been enhanced to ₹10 lakh per
family, compared to the ₹5 lakh coverage under Ayushman Bharat. However, the
effectiveness of these schemes depends on various factors, including timely fund
allocation, efficient implementation, and robust healthcare infrastructure.

Application of Mixed Methods in the Aarogyasri Scheme Evaluation

Mixed Methods Research (MMR) is a methodological approach that integrates
both qualitative and quantitative research techniques. This approach allows
researchers to draw on the strengths of both methodologies, providing a more
comprehensive understanding of complex research questions.
1. Quantitative Component
 Objective: To assess the statistical impact of the Aarogyasri Scheme on
health outcomes and healthcare utilization.
 Data Collection: Utilize surveys and health records to gather data on the
number of beneficiaries, types of treatments availed, hospitalization rates,
and health outcomes before and after the implementation of the scheme.
 Analysis: Employ statistical methods to analyze the data, identifying trends
and patterns that indicate the effectiveness of the scheme.
2. Qualitative Component
 Objective: To explore the personal experiences and perceptions of
beneficiaries regarding the Aarogyasri Scheme.
 Data Collection: Conduct in-depth interviews and focus group discussions
with beneficiaries to gather insights into their experiences with accessing
healthcare services under the scheme.
  Analysis: Use thematic analysis to identify common themes and narratives
that provide a deeper understanding of the beneficiaries' perspectives.
Integrated Results
Objective: To combine the numerical data with personal narratives to provide a holistic
evaluation of the Aarogyasri Scheme.
Method: Integrate the findings from both components to draw comprehensive conclusions about
the scheme's impact. For example, statistical data on increased healthcare utilization can be
complemented with qualitative insights into the reasons behind this increase.

Summary
The Rajiv Aarogyasri Community Health Insurance Scheme, launched by the
Government of Telangana in 2007, is a cornerstone of the state's healthcare
initiatives aimed at providing quality medical services to economically
disadvantaged individuals. With a mission to achieve "Health for All," the scheme
offers comprehensive coverage for a wide range of medical conditions, ensuring
that Below Poverty Line (BPL) families have access to necessary treatments
without financial strain.

Benefits:
Extensive Coverage: Aarogyasri encompasses over 3,255 listed surgeries and
therapies for approximately 1,000 illnesses, including heart diseases, kidney
conditions, cancer, and neurological disorders.
Cashless Treatment: Beneficiaries can avail themselves of cashless
hospitalization services at empaneled hospitals, eliminating the need for upfront
payments.
Financial Protection: The scheme provides financial assistance of up to ₹10 lakh
per family, covering secondary and tertiary care procedures.
Inclusive Coverage: It includes pre-existing diseases and offers follow-up services
for optimal post-treatment care.
Special Initiatives: Innovative programs, such as the "Orphan Health Card," have
extended coverage to differently-abled and orphaned children, ensuring they
receive necessary medical treatments and surgeries.

Drawbacks:
Limited Outpatient Care: The scheme primarily covers inpatient services,
leaving outpatient consultations and medications largely unaddressed.
Overdependence on Private Sector: The reliance on private hospitals has led to
concerns about the quality of care, with instances of substandard treatment and
exploitation.
Exclusion of Certain Procedures: High-end procedures like hip and knee
replacements, bone marrow transplants, and assisted devices for cardiac failures
are excluded from the scheme.
Implementation Challenges: Issues such as delayed reimbursements to hospitals
and discrepancies in empanelment have affected the smooth functioning of the
scheme.
Challenges:
Delayed Payments: Hospitals have reported delays in receiving payments from
the government, leading to reluctance in providing services under the scheme
Infrastructure Gaps: While the scheme has incentivized public hospitals through
a revolving fund for infrastructure improvements, disparities in facilities between
urban and rural areas persist
Monitoring and Oversight: Inadequate monitoring mechanisms have led to
instances of malpractice, such as unnecessary surgeries performed to exploit the
scheme's benefits.
Impact:
Widespread Beneficiaries: As of June 2024, the scheme benefits approximately
2.84 crore individuals across Telangana, providing them with access to essential
healthcare services.
Financial Relief: By covering high-cost treatments, the scheme has alleviated the
financial burden on low-income families, enabling them to seek timely medical
interventions.
Health Outcomes: The scheme has contributed to improved health outcomes by
facilitating access to specialized treatments that might otherwise be unaffordable.

Recent Enhancements:
Expansion of Coverage: In June 2024, the Telangana government added 65 new
medical treatments, including those for angiograms, Parkinson’s disease, and
spinal cord-related conditions, to the Aarogyasri scheme.
Increased Financial Allocation: The government released ₹497 crore to enhance
treatment packages and include additional procedures, reflecting a commitment to
improving healthcare accessibility.

Limitations of Study:
1. Integration Challenges between Quantitative and Qualitative Data
Combining quantitative and qualitative data poses significant challenges.
Differences in data collection methods, scales, and analytical techniques can
complicate the integration process. For instance, aligning numerical satisfaction
scores with thematic insights from interviews requires careful interpretation to
ensure coherence and meaningful conclusions. Without effective integration, the
study risks producing fragmented findings that may not fully capture the
complexities of the Aarogyasri Scheme's impact.

2. Resource and Time Constraints

MMR studies are resource-intensive, requiring substantial time, funding, and
expertise. The dual demands of collecting and analyzing both quantitative and
qualitative data can strain available resources. In the context of the Aarogyasri
evaluation, these constraints may limit the depth and breadth of the study,
potentially affecting the comprehensiveness of the findings.

3. Potential Researcher Bias

The involvement of researchers with varying expertise in quantitative and
qualitative methods can introduce biases. For example, a researcher with a strong
background in quantitative analysis might prioritize numerical data over qualitative
insights, or vice versa. Such biases can skew the interpretation of findings and
undermine the objectivity of the study.

4. Methodological Rigor and Transparency

Ensuring methodological rigor across both quantitative and qualitative components
is crucial. However, inconsistencies in standards and practices between the two
approaches can compromise the overall quality of the study. Moreover, a lack of
transparency in reporting methods and findings can hinder the reproducibility and
credibility of the research.
5. Sampling and Generalizability Issues
The sampling strategies employed in MMR studies can affect the generalizability
of the findings. For instance, if the qualitative component relies on a small, non-
representative sample, its findings may not accurately reflect the experiences of the
broader beneficiary population. Similarly, limitations in the quantitative sample
can impact the statistical power and generalizability of the results.
6. Ethical Considerations
MMR studies often involve complex ethical considerations, particularly when
dealing with sensitive health data. Ensuring informed consent, maintaining
confidentiality, and addressing potential power imbalances between researchers
and participants are critical. In the context of the Aarogyasri evaluation, these
ethical challenges must be carefully managed to protect participants' rights and
uphold the integrity of the research.

7. Structural and Contextual Limitations

The effectiveness of the Aarogyasri Scheme is influenced by various structural and
contextual factors, such as healthcare infrastructure, policy implementation, and
socio-economic conditions. These factors can introduce variability in how the
scheme operates across different regions, potentially affecting the consistency and
reliability of the study's findings.

8. Data Availability and Quality

Accessing comprehensive and accurate data is essential for both quantitative and
qualitative components of MMR. However, limitations in data availability,
accuracy, and completeness can hinder the study's ability to draw valid
conclusions. In the case of the Aarogyasri evaluation, challenges in obtaining
reliable data from various sources may affect the robustness of the research
findings
9. Potential for Overgeneralization
The desire to produce comprehensive findings can lead to overgeneralization,
where conclusions drawn from specific contexts are applied broadly. In the case of
the Aarogyasri evaluation, such overgeneralization could misrepresent the
scheme's impact across diverse populations and settings, potentially leading to
misguided policy recommendations.
 Scope for Further Research
While existing studies have provided valuable insights into its effectiveness,
several areas warrant further investigation to enhance the scheme's efficacy and
address emerging challenges.
Socioeconomic and Geographic Disparities
Studies have indicated significant variations in health insurance coverage across
different socioeconomic groups and geographic regions in India. Investigating the
factors contributing to these disparities within the context of the Aarogyasri
scheme could inform targeted interventions to ensure equitable access to healthcare
services.
Impact of Recent Policy Changes
The recent inclusion of 65 new treatment procedures under the Aarogyasri scheme
and the integration of Ayushman Bharat procedures present an opportunity to
evaluate the impact of these policy changes. Research could focus on assessing the
utilization rates, patient outcomes, and financial implications of these additions to
determine their effectiveness and identify areas for further improvement.
Evaluation of Public-Private Partnerships
The involvement of private hospitals in the Aarogyasri scheme has been shown to
improve access to healthcare services in underserved areas. Further research is
needed to assess the long-term impact of these public-private partnerships on
healthcare quality, provider behavior, and patient outcomes. Comparative studies
between regions with varying levels of private sector participation could provide
insights into optimizing such collaborations.
Expansion of Coverage to Non-Communicable Diseases (NCDs)
Recent studies have highlighted the substantial economic burden of NCDs such as
diabetes, hypertension, and cardiovascular diseases on households in Punjab.
These conditions often lead to catastrophic health expenditures, particularly among
lower-income groups. Despite government health insurance coverage, significant
gaps remain, especially in covering outpatient and diagnostic services. Research
suggests expanding insurance benefits to include outpatient and diagnostic
expenses for chronic conditions, including type-1 diabetes patients, to alleviate
financial strain on families

Conclusion:
The Aarogyasri scheme exemplifies how visionary leadership, combined with
innovative policy design, can transform the healthcare landscape for the betterment
of society. While challenges remain, the initiative's successes underscore the
potential of public health schemes in addressing the needs of the underserved
populations. As India continues to strive towards universal health coverage,
Aarogyasri remains a testament to the possibilities inherent in inclusive and
accessible healthcare systems.
The scheme's implementation through 1,402 empaneled hospitals across the state
ensures that beneficiaries have access to necessary medical treatments without the
burden of out-of-pocket expenses. This extensive network facilitates timely and
effective healthcare delivery, particularly in rural and underserved areas.
In addition to the general BPL population, the Aarogyasri scheme has extended its
benefits to vulnerable groups. The introduction of the "Orphan Health Card"
initiative has provided medical coverage to differently-abled and orphaned children
residing in Child Care Institutions (CCIs). This program ensures that these children
receive essential medical treatments and surgeries, which were previously
inaccessible due to financial constraints.
The Telangana government's proactive approach in enhancing the Aarogyasri
scheme underscores its commitment to achieving universal health coverage. By
continually expanding the scope of services and increasing financial allocations,
the government aims to ensure that every individual, regardless of economic status,
has access to quality healthcare. The scheme's success is evident in the improved
health outcomes and the alleviation of financial burdens for countless families
across the state.
While challenges persist, the scheme's impact on improving healthcare access is
undeniable. With continued commitment and strategic planning, Aarogyasri can
serve as a model for other states aiming to achieve universal health coverage.
In conclusion, the Rajiv Aarogyasri Scheme represents a significant stride towards
equitable healthcare in Telangana. Through its comprehensive coverage, inclusive
initiatives, and continuous enhancements, the scheme has made quality healthcare
accessible to those who need it the most. As the government continues to build
upon this foundation, the vision of universal health coverage becomes an
increasingly attainable reality for the people of Telangana.

Aarogyasri has had a profound impact on the healthcare landscape in Andhra

Pradesh:
 Improved Health Outcomes: The scheme facilitated timely treatments,
leading to better health outcomes for many beneficiaries.
 Economic Relief: By covering medical expenses, Aarogyasri alleviated the
financial burden on poor families, preventing them from falling deeper into
poverty.
 Model for Other States: The success of Aarogyasri inspired other states to
adopt similar models, contributing to the broader movement towards
universal health coverage in India.
In recognition of its achievements, Aarogyasri has been lauded both nationally and
internationally as a model for inclusive healthcare delivery.
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