Financial Sustainability of Ayushman Bharat: Addressing Provider Payment Delays and Healthcare Access

From a governance perspective, this crisis highlights the need for robust, technology-driven claim processing systems and transparent grievance redressal mechanisms. The reliance on private hospitals for public service delivery requires a sustainable financial model that accounts for the operational costs of healthcare providers. If the government fails to address these systemic bottlenecks, it risks alienating the private sector, which is essential for bridging the infrastructure gap in India’s public health system. Furthermore, such disruptions disproportionately affect the poor, who are the primary beneficiaries of the scheme, leading to a breach of the social contract between the state and its citizens. For policymakers, this situation serves as a case study in the challenges of public-private partnerships (PPPs) in the social sector. Ensuring the sustainability of AB-PMJAY requires not just budgetary allocation, but also administrative efficiency in the settlement of claims and a proactive dialogue with professional associations to maintain the continuity of essential services. UPSC Relevance: This issue is highly relevant for GS Paper II (Governance and Social Sector) and GS Paper III (Inclusive Growth). Aspirants can use this as a case study to discuss the challenges of implementing large-scale welfare schemes, the limitations of PPP models in healthcare, and the necessity of administrative accountability in public service delivery.