Union Health Minister J. P. Nadda on Wednesday, June 24, 2026, highlighted a landmark shift in India's healthcare architecture, asserting that for the first time a balanced and integrated linkage has been established across primary, secondary, and tertiary levels of care. He credited 1.81 lakh Ayushman Arogya Mandirs with strengthening the first point of contact for health services across rural and urban India.

Context

Nadda posted in Hindi, stating: 'स्वास्थ्य व्यवस्था को मजबूत बनाने के लिए पहली बार प्राइमरी, सेकेंडरी और टर्शियरी हेल्थ केयर के बीच बेहतर लिंकेज और संतुलित दृष्टिकोण अपनाया गया' ['For the first time, a better linkage and balanced approach has been adopted between primary, secondary, and tertiary healthcare to strengthen the health system']. The minister underlined that these facilities ensure citizens receive 'the right treatment and referral at the right time.'

The statement marks a deliberate effort by the Union Health Ministry to frame the Ayushman Bharat programme not merely as a hospitalisation insurance scheme, but as a structurally integrated, three-tier health delivery system.

Policy Backdrop

The Ayushman Bharat programme was launched in 2018 with two distinct pillars: Health and Wellness Centres targeting primary care, and the Pradhan Mantri Jan Arogya Yojana (PM-JAY) providing financial coverage for secondary and tertiary hospitalisation. The original target was to establish 1.5 lakh such primary care centres across the country.

The National Health Policy 2017 had explicitly recommended a tiered referral architecture to reduce fragmentation between care levels. The rebranding and expansion of these centres as Ayushman Arogya Mandirs represents the government's effort to operationalise that policy vision at scale. India has pursued a hub-and-spoke model under this framework to lower out-of-pocket expenditure and manage the rising burden of non-communicable diseases.

The emphasis on integrated, comprehensive primary healthcare marks a structural departure from earlier disease-specific vertical programmes, moving toward a model where the first point of contact manages, monitors, and refers patients across the care continuum.

Stakeholders and Impact

The primary beneficiaries of this network are rural and urban populations who previously faced barriers of distance, cost, and fragmented care pathways. By positioning Ayushman Arogya Mandirs as the first contact point, the government aims to reduce the burden on district hospitals and tertiary facilities caused by patients bypassing primary care.

Timely referrals from primary centres to PM-JAY-empanelled hospitals are central to the model's effectiveness. For patients in underserved areas, a functional referral chain can be the difference between early intervention and late-stage, costlier treatment.

What's Next

Attention will now turn to functional integration — whether these 1.81 lakh centres are operationally linked with district hospitals and empanelled tertiary facilities in practice, not just on paper. Health Ministry data on referral completion rates and state-level implementation reviews will be closely watched as indicators of whether the three-tier linkage Nadda described is translating into measurable outcomes on the ground.

As the government continues to scale the Ayushman Bharat ecosystem, the success of this integrated model could define the template for public health delivery in India for the next decade.