Hyderabad: Telangana’s revamped Employee Health Scheme (EHS) is facing implementation challenges as private hospitals raise concerns over delayed payments, low package rates and a reported backlog of medical bills exceeding Rs 2,000 crore.
The financial strain is also raising concerns over the functioning of the EHS and the Aarogyasri health scheme, particularly among small and medium-sized private hospitals that form a significant part of the state’s healthcare network.
Despite the Telangana government introducing a mandatory deduction of 1.5 per cent from the basic pay of state employees and pensioners to fund the Employee Health Care Trust (EHCT), a large number of private hospitals have not joined the revamped EHS.
According to Telangana Aarogyasri Network Hospitals Association (TANHA) president Dr Vaddiraju Rakesh, private hospitals have pending Aarogyasri bills of more than Rs 2,000 crore, accumulated over nearly 15 months, along with older EHS dues.
Dr Rakesh said the delayed payments have made it difficult for small and medium hospitals to absorb operational costs and participate in the new EHS. According to the association, none of the 360 small and medium-sized private hospitals have signed MoUs to provide services under the revamped scheme.
Hospital representatives have also raised concerns over the rates offered for medical procedures under the new EHS. They contend that several package rates are lower than those offered under previous arrangements, making it difficult for smaller hospitals to provide treatment without incurring losses.
For example, a procedure that previously attracted a payment of Rs 32,100 under Aarogyasri and was subsequently revised to Rs 40,000 has been fixed at Rs 26,500 under the new EHS structure, according to the association.
Hospital representatives argue that the combination of lower package rates and delayed reimbursements leaves little room to meet staff salaries, maintenance expenses and other operational costs.
The association has also raised concerns about differences between the participation of corporate hospitals and smaller healthcare providers. According to Dr Rakesh, some corporate hospitals have joined the EHS framework with provisions allowing additional payments for services such as room upgrades and diagnostics.
Small and medium hospitals, particularly those operating in districts, do not have similar revenue options, the association said.
The dispute comes as the state government seeks to implement the revamped EHS while continuing healthcare coverage through Aarogyasri. Private hospitals have called for timely settlement of outstanding bills and revision of package rates to make participation financially sustainable.
The government has yet to resolve the concerns raised by the network hospitals, while the absence of MoUs with the 360 small and medium hospitals remains a major hurdle for expanding the revamped EHS across Telangana.
