Navigating Financial Sustainability in India's Private Healthcare Under Ayushman Bharat: Challenges, Opportunities, and Global Comparisons.

Abstract

The healthcare system of India has a major issue of inequality in the accessibility, quality among the public and private sector. These gaps have been addressed through Ayushman Bharat scheme initiated in 2018 to enhance access to healthcare in both sectors. This paper will explore the implication of Universal Health Schemes (UHS) or in this case Ayushman Bharat on the private hospital facilities. It examines impacts on revenues, operational expenses, long term budgetary sustainability and the new phenomenon of voluntary opt-outs provided a comparative approach to other economies. The systematic literature review adopted a PRISMA format to identify 54 relevant pieces of literature published between 2015 and 2024 based on PubMed, Scopus, Web of Science, and Google Scholar. Thematic coding was used to determine the following four themes that comprised of the findings: financial strain, operational burden, growth opportunities and cross-country insights. The findings indicate that Ayushman Bharat has caused growth in the number of patients but not an equivalent increment in revenues because of low reimbursement rates and delayed payment. Costs of operation have also increased. Nevertheless, there are prospects of growing services and nuturing public-private collaboration in case payment deficiencies and administrative obstacles are accommodated by policies. The increasing possibility of hospital opt-outs is a menace to the scheme sustainability. Accordingly, proper reimbursement, payment and low bureaucracies are necessary to sustain the input of the private sector and attain universal health coverage.