NABH accreditation now mandatory for chief minister’s insurance scheme empanelment
TNN | May 12, 2017, 12.27 AM IST
CHENNAI: After requesting and demanding hospitals to follow a protocol to maintain standards, the state has now made it mandatory for all medical institutions to get a certificate from the National Accreditation Board for Hospital and Healthcare providers if they want to continue their contract under the chief minister's insurance scheme.
According to the new empanelment policy under the Chief Minister' Comprehensive Health Insurance Scheme (CMCHIS), hospitals, both government and private, have to get basic level accreditation from NABH - a quasi-government body - within a year of them coming under the programme. Failing this, the state will terminate the contract.
Of the total 790 hospitals that were empanelled before the new policy came into force in January this year, 500 have renewed their contract. Of this only around 40 have NABH certificates.
T S Selvavinayagam, director of community medicine at Madras Medical College who is currently in charge of CMCHIS said the state had so far been insisting on the certificate only orally. "Our previous policy had mentioned high standards in hospitals as criteria for empanelment but didn't specify NABH. It was done more on voluntary basis," said Dr Selvavinayagam. In 2014, the government had set up a help centre to exclusively guide hospitals in obtaining NABH certificates. It also negotiated with the body to reduce the accreditation fee. The government even offered to increase reimbursement rates for accredited hospitals in an effort to lure them. Many private hospitals in the state get nearly 60% of their total revenue from the insurance scheme.
The NABH accreditation involves around 636 elements related to patient care. Tamil Nadu Health Systems Project which is tasked with implementing the scheme has asked hospitals to obtain an entry-level accreditation by following 30% of the total elements.
Through this, the state hopes to bring down complaints by patients who come under the scheme. "In some cases the complaints are directly linked to the treatment, like incorrect medication or negligence. But most return saying their treatment was delayed because of lack of infrastructure or manpower," said an official. The insurance covers 686 surgical and 215 medical procedures. From 2012 the scheme has covered the treatment of 17.63 lakh patients at a cost of more than Rs3,000 crore.
Dr Harish Nadkarni, chief executive officer of NABH, said around 225 medical institutions in Tamil Nadu have accreditation at present, including government and private hospitals and smaller nursing homes. Once they are recognized by the body, a team will be sent to undertake inspections once in 18 months. "In addition we will also conduct surprise visits. If we find any discrepancy, we will withdraw the certificate," he said.
Doctors TOI spoke to said one of the biggest problem they face while applying for the certificate is the massive paperwork involved.
TNN | May 12, 2017, 12.27 AM IST
CHENNAI: After requesting and demanding hospitals to follow a protocol to maintain standards, the state has now made it mandatory for all medical institutions to get a certificate from the National Accreditation Board for Hospital and Healthcare providers if they want to continue their contract under the chief minister's insurance scheme.
According to the new empanelment policy under the Chief Minister' Comprehensive Health Insurance Scheme (CMCHIS), hospitals, both government and private, have to get basic level accreditation from NABH - a quasi-government body - within a year of them coming under the programme. Failing this, the state will terminate the contract.
Of the total 790 hospitals that were empanelled before the new policy came into force in January this year, 500 have renewed their contract. Of this only around 40 have NABH certificates.
T S Selvavinayagam, director of community medicine at Madras Medical College who is currently in charge of CMCHIS said the state had so far been insisting on the certificate only orally. "Our previous policy had mentioned high standards in hospitals as criteria for empanelment but didn't specify NABH. It was done more on voluntary basis," said Dr Selvavinayagam. In 2014, the government had set up a help centre to exclusively guide hospitals in obtaining NABH certificates. It also negotiated with the body to reduce the accreditation fee. The government even offered to increase reimbursement rates for accredited hospitals in an effort to lure them. Many private hospitals in the state get nearly 60% of their total revenue from the insurance scheme.
The NABH accreditation involves around 636 elements related to patient care. Tamil Nadu Health Systems Project which is tasked with implementing the scheme has asked hospitals to obtain an entry-level accreditation by following 30% of the total elements.
Through this, the state hopes to bring down complaints by patients who come under the scheme. "In some cases the complaints are directly linked to the treatment, like incorrect medication or negligence. But most return saying their treatment was delayed because of lack of infrastructure or manpower," said an official. The insurance covers 686 surgical and 215 medical procedures. From 2012 the scheme has covered the treatment of 17.63 lakh patients at a cost of more than Rs3,000 crore.
Dr Harish Nadkarni, chief executive officer of NABH, said around 225 medical institutions in Tamil Nadu have accreditation at present, including government and private hospitals and smaller nursing homes. Once they are recognized by the body, a team will be sent to undertake inspections once in 18 months. "In addition we will also conduct surprise visits. If we find any discrepancy, we will withdraw the certificate," he said.
Doctors TOI spoke to said one of the biggest problem they face while applying for the certificate is the massive paperwork involved.
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