PESHAWAR: The Khyber Pakhtunkhwa health department has increased the rates of cardiac procedures under the health insurance scheme Sehat Card Plus by 40 per cent, citing the rising costs of medical implants, medicines, diagnostic reagents, and utility charges as the reason.

The development came during a meeting of the policy board for the Sehat Card Plus here on Saturday with health minister Syed Qasim Ali Shah in the chair.

The meeting, which took place on the directives of Chief Minister Ali Amin Khan Gandapur, was attended by CEO of the Sehat Card Plus Dr Mohammad Riaz Tanoli, health secretary Adeel Shah, director-general (health services) Dr Mohammad Salim Khan and other relevant officials.

The participants decided that the hospitals performing cardiac procedures would get higher payments from next month.

Move comes from policy board for health insurance scheme at request of hospitals

Officials told Dawn that the rate hike was a longstanding demand of hospitals empaneled for the Sehat Card Plus and was driven by the significant increase in implant prices due to rupee depreciation against the US dollar.

They said the hospitals imported implants in dollars, so they requested a rate revision, which was approved by the board.

The officials said the decision would result in a 40 per cent hike in payments for 26 cardiac interventions under the Sehat Card Plus.

They said the hospitals’ demand was discussed two months ago as many were unhappy with the 2016 rates, and that their request for hike in the procedures’ rates was justified.

The officials said currently, around a dozen hospitals in the province were offering cardiac services under the SCP.

They said 27 per cent of the SCP’s budget was consumed by the services provided to heart patients because the cardiac procedures were so expensive that the people couldn’t afford them.

Officials claimed that the move would benefit patients in the form of “smooth” care.

They said most heart patients had to wait for a long time to undergo procedures as hospitals falsely claimed to be without beds to admit them though the real issue was the lower rates offered by the government.

The officials said some senior cardiologists and heart surgeons flatly refused to check and operate on patients under the SCP as they earned more from private patients.

They said after rate hikes, it was hoped that reputed surgeons would start treating cardiac patients under the government’s health insurance scheme.

The officials said a committee comprising all stakeholders was formed to discuss the matter and produce a report within three weeks.

They added that the hospitals had demanded an increase of over 50pc, arguing that the current rates were far less than the market’s, so it was difficult for them to carry ahead with services.

The officials said the committee’s report declared that the programme was meant to provide quality health services to residents, so hiking procedure rates was imperative.

In the meeting, the minister said he won’t tolerate any compromise on the quality of services under the SCP. He directed hospitals to ensure visitors receive the best possible care.

Published in Dawn, July 14th, 2024

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