Bishwajit Nayak

Accreditation Guidelines for Hospitals in a Preferred Provider Network: Developing Accreditation Guidelines for Empanelling Hospitals in a Preferred Provider Network - an Indian Perspective Bishwajit Nayak

In India, healthcare facilities function in an environment of a plethora of regulations, but no body to enforce the laws and no interest even on the part of the market constituents to adhere to such laws. The recent privatization of the insurance industry has raised hopes that the hospitals would now be under pressure to satisfy norms or face a loss in the market share. Health Insurance has existed in the form of Mediclaim schemes which laid out certain specifications for hospitals but had inherent loopholes that rendered the norms useless. This report is an attempt to give a formal shape to the process of performance review of hospitals with an aim of helping consumers to make a better choice. Since the future of healthcare in India entails patients being chanelled through insurance firms, so the thesis work focused on developing accreditation guidelines for empanelling hospitals in a preferred provider network. Although, this report does not emphatically claim to provide a full fledged evaluation of hospitals, it is expected to be a basic framework which can be used by health insurers for screening hospitals.