Health Industry Bodies Celebrate CGHS Rate Revision?
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Synopsis
On October 4, health industry bodies applauded the government's decision to revise CGHS package rates for nearly 2,000 medical procedures. This change aims to improve healthcare delivery and efficiency, benefiting both providers and patients alike. With the last revision occurring in 2014, this update is considered essential for addressing long-standing issues in the sector.
Key Takeaways
- The CGHS package rates are updated for nearly 2,000 procedures.
- The changes will take effect from October 13.
- Rates will vary based on city tiers and hospital accreditation.
- This revision aims to improve healthcare accessibility and efficiency.
- NATHEALTH suggests periodic benchmarking to the Consumer Price Index.
New Delhi, Oct 4 (NationPress) Health industry organizations have expressed their support for the central government’s initiative to update the package rates for approximately 2,000 medical procedures under the Central Government Health Scheme (CGHS).
The newly revised rates, which were revealed on Oct 3, will take effect from Oct 13.
“This significant reform, in conjunction with the previous GST relief, showcases the government’s dedication to enhancing healthcare delivery and addressing long-standing issues within the sector,” stated Ameera Shah, President of NATHEALTH.
The CGHS serves as a crucial program for millions of beneficiaries, and these new rates are expected to enhance access to safe and effective healthcare while improving system efficiency.
Previously, the Association of Healthcare Providers of India (AHPI) referred to the rate revision as “a long-overdue measure.”
The last package rates were set in 2014, with only a minor update in 2024, leaving both hospitals and patients grappling with a significant gap between the actual treatment costs and the established package rates for over a decade.
This new policy is anticipated to deliver advantages to both healthcare providers and CGHS beneficiaries, according to the AHPI.
The revamped framework will apply to CGHS cardholders across all categories, with semi-private rooms defined as accommodating two to four patients forming the basis for package rates, while general wards will host up to 10 patients.
The rates will also differ based on city tiers, with tier-I cities applying the base rate, tier-II cities—such as Chandigarh, Jalandhar, and Ludhiana—set at a 19% lower rate, and tier-III cities at a 20% lower rate.
Additionally, accreditation status will influence rates, with non-NABH hospitals receiving a 15% lower rate compared to NABH hospitals, while super-specialty hospitals with over 200 beds will be eligible for a 15% higher rate than NABH hospitals.
Continuing this positive trend, NATHEALTH proposed that CGHS and other government-sponsored schemes be routinely benchmarked against the Consumer Price Index (CPI).
“This approach will promote predictability, sustainability, and a mutually beneficial value proposition for patients, providers, and policymakers,” remarked Shah.
Point of View
We recognize the government's timely intervention in revising CGHS rates as a crucial step towards enhancing healthcare accessibility. This move, welcomed by various industry bodies, indicates a positive shift in addressing long-standing concerns in the health sector. By aligning package rates more closely with actual treatment costs, the government is taking a significant stride in ensuring better healthcare delivery for all.
NationPress
04/10/2025
Frequently Asked Questions
What are the new changes in the CGHS rates?
The new CGHS rates, effective from October 13, will cover nearly 2,000 medical procedures and provide varied rates based on city tiers and hospital accreditation.
When were the last rates revised?
The last package rates were set in 2014, with only a minor update in 2024, leaving a significant gap until now.
How will the changes affect healthcare providers?
The revised rates are expected to benefit healthcare providers by aligning the reimbursement rates with actual treatment costs, ensuring sustainability.
What is the significance of this rate revision?
This rate revision is crucial for enhancing healthcare delivery and addressing long-standing issues within the sector, improving access for patients.
Who will benefit from the updated CGHS rates?
Both healthcare providers and CGHS beneficiaries will benefit from the updated rates, improving access to healthcare services.
