REPORT ON TOP UTILIZED PRIVATE

HOSPITALS

Ayushman Bharat- Pradhan Mantri Jan Arogya

Yojana (AB PM-JAY)

National Health Authority

Ayushman Bharat – Pradhan Mantri Jan
Arogya Yojana (PMJAY)

1
 Table of Contents
Background ........................................................................................................................................................ 3
Utilization In Public and Private Hospitals .......................................................................................................... 4
Speciality Wise Utilization: ................................................................................................................................. 4
Procedure Wise Utilization: ................................................................................................................................ 5
Choice of provider by beneficiary ....................................................................................................................... 5
Understanding utilization in Private Hospitals .................................................................................................... 6
Preliminary findings ............................................................................................................................................ 7
Way forward ....................................................................................................................................................... 9
State Wise Analysis: ........................................................................................................................................10
1. Tamil Nadu: .........................................................................................................................................10
2. Gujarat: ................................................................................................................................................13
3. Chhattisgarh: .......................................................................................................................................16
4. Maharashtra: .......................................................................................................................................19
5. Kerala: .................................................................................................................................................22
6. Jharkhand ............................................................................................................................................25
7. Karnataka: ...........................................................................................................................................28
8. Uttar Pradesh ......................................................................................................................................31
9. Madhya Pradesh: ................................................................................................................................34
10. Bihar: ...................................................................................................................................................37
11. Uttarakhand .........................................................................................................................................40
12. Assam:.................................................................................................................................................43
13. Meghalaya ...........................................................................................................................................46
14. Haryana: ..............................................................................................................................................49
15. Jammu & Kashmir ...............................................................................................................................52
16. Tripura .................................................................................................................................................55
17. Himachal Pradesh ...............................................................................................................................57
18. Mizoram: ..............................................................................................................................................60
19. Andhra Pradesh: .................................................................................................................................62
20. Manipur:...............................................................................................................................................65
21. Chandigarh: .........................................................................................................................................67
22. Nagaland: ............................................................................................................................................69
23. Punjab .................................................................................................................................................71

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 Background
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana
(AB PM-JAY) was launched by Hon’ble Prime Minister on
23rd Sep 2018. The largest health financing scheme in
the world entitles approximately 50 crore beneficiaries
listed in SECC 2011 census to hospitalization benefits up
to Rs. 5 lakhs per family per annum. The benefits under
the Scheme are portable across the country at any
empanelled hospital. The Scheme has been
implemented in 32 States and Union Territories. 1393
procedures under 23 specialities are covered under the
Scheme.

Public and Private Hospitals Empanelled

As on August 31st, 2019,
15,968 hospitals are empanelled under AB PM-JAY which
include 7,446 public hospitals and 8,522 private hospitals
(including not-for-profit entities). Since the launch of the
Scheme, over 40 Lakh beneficiaries have utilized benefits. As
one of the key objectives of the scheme is to increase the
availability and choice of healthcare facilities where
beneficiaries could avail free treatment, both public and
private hospitals have been empanelled in almost equal
proportion under the scheme.

Tamil Nadu accounts for the highest

volume of claims at 28% followed by
Gujarat at 17.2% and Chhattisgarh at
14.6%. The map alongside depicts the
distribution of overall claims across the
implementing states and UTs with the
colour intensity indicating the
descending order of claims volume.

3
Utilization in Public and Private Hospitals:
Over 40 Lakh beneficiaries have utilized benefits at both public and private hospitals across
different specialities, with 63% of total claims being utilised in private hospitals.

Speciality Wise Utilization:

As regards utilisation in different specialities, General Surgery accounted for the highest
utilized specialty at 27% followed by General Medicine at 18.5% and Urology at 12%
across all States.

*Size of the boxes and intensity of colour represents higher number of claims

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Procedure Wise Utilization:
Looking at the top utilised procedures, day care procedures such as Haemodialysis account
for the maximum number of cases (39% of total cases) followed by Cataract Treatment
using Phaco-Emulsification Technology (3.3%) and Chemotherapy (2.7%).

Choice of provider by beneficiary:

The approach to empanelment of private providers by different states is governed by their
existing public health infrastructure and its capacity to provide treatment for different
specialities with availability of specialist manpower. Certain States have adopted a policy to
empanel only a limited number of hospitals that meet their requirement (e.g. Maharashtra),
while certain States have reserved packages for public hospitals (e.g. Bihar, MP) and States
such as Uttarakhand has adopted a policy of referral from a public hospital for every
procedure to be carried out at a private hospital.
NHA has recommended few abuse prone packages to be reserved exclusively for public
hospitals. Few States have adopted the list as is, while few others have added more
packages depending on capacity of public hospitals and other local factors.

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 State-wise Packages Reserved for Public Hospital
S.no State Name No. of packages reserved for Public
Hospitals

1 Gujarat 231
2 Chhattisgarh 66
3 Tamil Nadu 681
4 Maharashtra 539
5 Kerala 236
6 Jharkhand 19
7 Karnataka 443
8 Uttar Pradesh 71
9 Madhya Pradesh 473
10 Bihar 19
11 Uttarakhand 19
12 Assam 232
13 Meghalaya 19
14 Haryana 303
15 Jammu And Kashmir 19
16 Tripura 19
17 Himachal Pradesh 31
18 Mizoram 46
19 Andhra Pradesh 19
20 Manipur 20
21 Chandigarh 19
22 Nagaland 19
23 Punjab 19

Thus, a beneficiary’s choice to avail the benefits for a particular procedure is dependent on
multiple factors besides accessibility.

Understanding utilization in Private Hospitals:

As the Scheme implementation completes one year, analysis of top utilized hospitals in
different states shall be useful in:
- understanding the empanelled providers’ capacity utilization
- ascertaining preference of certain providers for different procedures by beneficiary
- examining trends of high utilization/skewedness
- determining whether high utilization is supported by plausible reasons or warrants
closer scrutiny
- addressing skewedness through policy design, system controls and monitoring

6
It is expected that large public hospitals at District level or Government medical colleges
would have higher utilization. While it is desirable to study utilization patterns of public
facilities also, this report examines only top most utilized private providers in 23
implementing States/UTs (with more than 1000 cases of utilisation) so that further policies
and decisions as regards participation of private providers can be made on informed basis
at National and State level.

Preliminary findings:
This Report has considered data of all beneficiaries including beneficiaries covered by
States in addition to PMJAY from all implementing States/UTs for the period September
23rd, 2018 i.e. inception of Scheme or State implementation date to August 31st, 2019. 23
States/UTs which had claim count of more than 1000 claims have been included in the
report . The report primarily analyses the data based on the number of claims and not the
value of claims, ‘claim’ denoting one episode of care utilisation at a hospital.
1. Private hospitals accounted for 63% of claims under PMJAY on overall basis. The
below map depicts state-wise distribution of claims in private hospitals with the colour
intensity in descending order of the volume of claims coming from private hospitals.

2. The trend of higher number of claims in private hospitals is seen for all States/UTs
except Kerala, Karnataka, Assam, MP and Bihar.

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 3. Amongst the top specialties being utilised in Private hospitals, General surgery
accounts for the highest at 32% followed by Urology at 14.4% and General Medicine
at 12.38%.

4. Haemodialysis accounted for 45% of total claims followed by Cataract at 5% and

Chemotherapy for Palliative Care at 3% as regards procedures carried out in private
hospitals.

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 5. Large private hospitals (more than 100 beds) and medical colleges which primarily
provide tertiary care, account for more than 60% of claims (including all procedures
including day care procedures) from private hospitals.
6. Smaller hospitals with high number of claims primarily cater to day care procedures
such as Haemodialysis, Cataract and Chemotherapy for Palliative Care.
7. In case of States, which had an ongoing stable health insurance scheme such as
Maharashtra, Karnataka, Gujarat prior to joining PM-JAY, such States have mostly
reserved medical procedures for public hospitals and hence private hospitals
primarily provide care for Cardiology, Medical Oncology and Orthopaedics
specialities in these states.
8. In case of States with limited prior experience of health insurance, such as
Jharkhand, MP and Bihar, packages like General Medicine and Ophthalmology
account for the highest contributors of utilization of care at private hospitals.
9. Dental Care accounts for the highest utilisation in private hospitals for the State of
Chhattisgarh, it is the only State where Dental procedures are covered.
10. There are few hospitals with high transaction volumes spread across different
states, where the reason for beneficiary preference/high utilization of the hospital as
compared to other providers is not very apparent. Some of these hospitals are
already being monitored by States, few having been issued show-cause notice
subsequent to medical audits undertaken by National Anti-Fraud Unit (NAFU) and
State Anti-Fraud Units (SAFU).

Way forward:
1. Further in-depth analysis of top utilized private hospitals shall be conducted with inputs
from State authorities. This will be coupled with medical audits to ascertain the
authenticity of the claims for the hospitals that are flagged amongst high utilization
without plausible explanation to identify unethical and fraudulent entities and further
action shall be initiated.
2. The National Anti-Fraud Unit Forensics Team is in the process of developing a
Comprehensive Pan-India Forensics Monitoring Capability (RADAR) which would
enable the States to monitor and keep watch over utilisation at different hospitals on real
time basis. Presently Insights Dashboard provides detailed view of claims and utilisation,
profiled at different aggregate levels for the States/UTS.
3. NAFU Forensics Team is also developing a process for sharing triggered/suspect
claims with States on real time basis with application of Artificial Intelligence and Machine
Learning techniques. Presently, this is being done in batch-mode and shared with States
on regular basis.
4. Real-time triggers shall be supported by field investigation through GPS enabled Mobile
App, end to end integrated with Transaction Management System to stop approvals and
payment of fraudulent claims.

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State Wise Analysis:
(States are listed in descending order of utilization)

1. Tamil Nadu:

District wise distribution

Distribution of Cases by Public and Private:

10
Speciality Wise Distribution of All Hospitals and Private only:

Highest Utilized Private Hospitals:

Count Action
Sl. Number NABH Plausible reason
Hospital Name of taken
No of beds Status for high utilization
cases (if any)

Not Not
VELAMMAL MC HOSP AND available available High incidence of
1 26,929
RESEARCH INSTITUTE. in NHA in NHA haemodialysis
HEM HEM

Historically best
Not Not performing hospital
DHANALAKSHMI SRINIVAS available available in state
2 16,481
HOSPITAL in NHA in NHA
HEM HEM High incidence of
haemodialysis

Not Not
SRI MOOKAMBIKA INST OF available available High incidence of
3 14,014
MED SCS HOSP in NHA in NHA haemodialysis
HEM HEM

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 Not Not
MANAKULA VINAYAGAR available available High incidence of
4 12,555
MEDICAL COLLEGE in NHA in NHA haemodialysis
HEM HEM

Not Not
available available High incidence of
5 SPMM HOSPITAL AMMAPET 12,272
in NHA in NHA haemodialysis
HEM HEM

Not Not
RAMANA available available High incidence of
6 11,894
MAHARISHI HOSPITAL in NHA in NHA haemodialysis
HEM HEM

Not Not
DR.K.M.NALLASWAMY available available High incidence of
7 11,733
HOSPITAL in NHA in NHA haemodialysis
HEM HEM

Not Not
JEYANTH NALLATHAMBI available available High incidence of
8 11,681
HOSPITAL in NHA in NHA haemodialysis
HEM HEM

Not Not
DR MORRIS MATHIA available available High incidence of
9 11,537
HOSPITAL in NHA in NHA haemodialysis
HEM HEM

Not Not
TANKER FOUNDATION available available High incidence of
10 11,328
DIALYSIS CENTRE in NHA in NHA haemodialysis
HEM HEM

12
2. Gujarat:

District Wise Utilisation and State Wise Details:

Distribution of Cases by Public and Private :

13
Speciality Wise Distribution of All Hospitals and Private only:

Highest Utilized Private Hospitals

Count Action
Sl. Number of NABH Plausible reason for taken
Hospital Name of
No beds Status high utilization
cases (if any)

Not
Not
B.T. SAVANI KIDNEY available High incidence of
1 available in 26,367
HOSPITAL in NHA dialysis cases
NHA HEM
HEM

KIRAN MULTI SUPER Not

Not
SPECIALITY available High incidence of
2 available in 22,247
HOSPITAL & in NHA dialysis cases
NHA HEM
RESEARCH CENTRE HEM

Not
Not
STERLING HOSPITAL available High incidence of
3 available in 14,857
- VADODARA in NHA dialysis cases
NHA HEM
HEM

Not High incidence of

4 STERLING available in 14,488 Not dialysis cases and
RAMKRISHNA NHA HEM available chemotherapy

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 SPECIALITY in NHA
HOSPITAL HEM

Not
Not High incidence of
STERLING HOSPITAL, available
5 available in 13,474 dialysis cases and
RAJKOT in NHA
NHA HEM cardiology
HEM

Not
NARAYANA Not
available High incidence of
6 HRUDAYALAYA available in 13,459
in NHA dialysis cases
PVT.LTD NHA HEM
HEM

Not
N. M. VIRANI Not
available High incidence of
7 WOCKHARDT available in 11,679
in NHA cardiology cases
HOSPITAL, RAJKOT NHA HEM
HEM

Not
SHREE KRISHNA Not
available High incidence of
8 HOSPITAL & MEDICAL available in 11,494
in NHA dialysis cases
RESEARCH CENTER NHA HEM
HEM

Not
HIMALAYA CANCER Not
available Cancer institute; high
9 HOSPITAL AND available in 10,409
in NHA chemotherapy cases
RESEARCH CENTRE NHA HEM
HEM

Not
KAILASH CANCER Not
available Cancer institute; high
10 HOSPITAL AND available in 10,025
in NHA chemotherapy cases
RESEARCH CENTRE NHA HEM
HEM

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3. Chhattisgarh:

District Wise Utilisation and State Wise Details:

Distribution of Cases by Public and Private :

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Speciality Wise Distribution of All Hospitals and Private only:

Highest Utilized Private Hospitals :

Action
Plausible reason
Sl. Number Count of NABH taken (if
Hospital Name for high
No of beds cases Status any)
utilization
Large hospital in
the interiors; High
Not Not patient footfall Show cause
DHAMTARI CHRISTIAN available available
1 11,713 Audit revealed notice
HOSPITAL in NHA in NHA
satisfactory issued
HEM HEM
findings with few
aberrations
SRI BALAJI INSTITUTE Not Not Large hospital in
available available
2 OF MEDICAL SCIENCE 9,648 the interiors; High
in NHA in NHA
PVT LTD patient footfall
HEM HEM
SHRI GANESH Not Show cause
available NABH High incidence of
3 VINAYAK EYE 9,241 notice
in NHA ENTRY cataract
HOSPITAL issued
HEM

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 Audit revealed
instances of
abuse
High incidence of
Not Not cataract; high risk
VINAYAK available available
4 8,444 suspect hospitals
NETRALAYABILASPUR in NHA in NHA
Audit revealed
HEM HEM
aberrations
SHRI Not Not Large hospital in
SHANKARACHARYA available available
5 7,549 the interiors; High
INSTITUTE OF in NHA in NHA
patient footfall
MEDICAL SCIENCE HEM HEM
CHATURVEDI DENTAL Not Not
available available Large number of
6 CLINIC AND IMPLANT 6,744 Suspended
in NHA in NHA dental cases
CENTRE
HEM HEM
High risk;
Not Not Suspect hospital Show cause
available available
7 MPM HOSPITAL 5,862 Audit revealed notice
in NHA in NHA
instances of issued
HEM HEM
abuse
High incidence of
Not Not cataract
ASG HOSPITAL PVT. available available
8 5,725 Audit revealed
LTD. in NHA in NHA
satisfactory
HEM HEM
findings
Not Not High incidence of
dental packages Under
available available
9 BALANI HOSPITAL 5,614 process by
in NHA in NHA Audit revealed
SHA
HEM HEM some aberrations
OM Not Not
available available High incidence of
10 SUPERSPECIALITY 5,257
in NHA in NHA dental packages
DENTAL CLINIC
HEM HEM

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4. Maharashtra:

District Wise Utilisation and State Wise Details:

Distribution of Cases by Public and Private:

19
Speciality Wise Distribution of All Hospitals and Private only:

Highest Utilized Private Hospitals:

Sl. Hospital Name Number of Count of NABH Plausible reason Action

No beds cases Status for high utilization taken
(if any)
1 PDVVP Not 11,649 Not Big Hospital; High
FOUNDATIONS available available in patient footfall
DR VIKHE PATIL in NHA NHA HEM
MEMORIAL HEM
HOSPITAL AND
MEDICAL
COLLEGE
2 HCG MANAVTA Not 11,005 Not High incidence of
PVT LTD available available in palliative cancer
in NHA NHA HEM care
HEM
3 INDRAYANI Not 8,903 Not Cancer
HOSPITAL & available available in Hospital/Institute ;
CANCER in NHA NHA HEM High number of
INSTITUTE HEM Chemotherapy
4 KRISHNA Not 8,630 Not High incidence of
HOSPITAL AND available available in palliative cancer
MEDICAL NHA HEM care

20
 RESEARCH in NHA
CENTRE, KARAD HEM
5 ASHWINI RURARL Not 8,438 Not Cancer
CANCER available available in Hospital/Institute ;
RESEARCH AND in NHA NHA HEM High number of
RELIEF SOCIETY HEM Chemotherapy
6 RASHTRIYA SANT Not 8,124 Not Cancer
TUKDOJI available available in Hospital/Institute;
MAHARAJ in NHA NHA HEM High number of
CANCER HEM Chemotherapy
HOSPITAL &
RESEARCH
CENTRE
7 NAMCO Not 7,378 Not Cancer
CHARITABLE available available in Hospital/Institute;
TRUST SGS in NHA NHA HEM High number of
CANCER HEM Chemotherapy
HOSPITAL
8 MMRI Not 6,580 Not High incidence of
KAMALNAYAN available available in palliative cancer
BAJAJ HOSPITAL in NHA NHA HEM care
HEM
9 DEEPAK Not 5,569 Not High incidence of
HOSPITAL available available in palliative cancer
in NHA NHA HEM care
HEM
10 KOLHAPUR Not 5,527 Not Cancer
CANCER CENTRE available available in Hospital/Institute;
in NHA NHA HEM High number of
HEM Chemotherapy

21
5. Kerala:

District Wise Utilisation and State Wise Details:

Distribution of Cases by Public and Private :

22
Speciality Wise Distribution of All Hospitals and Private only:

Highest Utilized Private Hospitals

Action
Number Count of NABH Plausible reason for high
Sl.No Hospital Name taken (if
of beds cases Status utilization
any)
MALABAR
MEDICAL Not Private Medical College;
Not
available
1 COLLEGE & 5,993 available in High footfall of patients;
in NHA
RESEARCH NHA HEM Catered to flood victims
HEM
CENTRE
SREE
GOKULAM
Not Private Medical College;
MEDICAL
2 630 4,338 available in No other established
COLLEGE AND
NHA HEM hospitals nearby
RESEARCH
FOUNDATION
Not Private Medical College;
KMCT MEDICAL
available NABH No other established
3 COLLEGE 4,327
in NHA ENTRY hospitals nearby
HOSPITAL
HEM Catered to flood victims
Private Medical College;
DM WAYANAD Not
4 4,062 NABH No other established
INSTITUTE OF available
hospitals nearby

23
 MEDICAL in NHA Catered to flood victims
SCIENCES HEM
DR.SM CSI Not
Not Private Medical College;
MEDICAL available in
available NHA HEM High footfall of patients;
5 COLLEGE AND 2,677
in NHA Audit revealed
HOSPITAL
HEM satisfactory findings
KARAKONAM
PUSHPAGIRI Not Not Private Medical College;
MEDICAL available available in No other established
6 2,627 NHA HEM
COLLEGE in NHA hospitals nearby
HOSPITAL HEM Catered to flood victims
KAMATH Not Not
available available in High incidence of dialysis
7 MEDICAL 2,210
in NHA NHA HEM cases
CENTRE
HEM
CHRISTIAN Not Private Medical College;
MISSION available NABH No other established
8 2,206
HOSPITAL, in NHA PREENTRY hospitals nearby
PANDALAM HEM Catered to flood victims
Not Private Medical College;
SAGARA Not
available No other established
9 HOSPITAL 1,738 available in
in NHA hospitals nearby
PUNNAPRA NHA HEM
HEM Catered to flood victims
Not Private Medical College;
ST.THOMAS Not
available No other established
10 MISSION 1,661 available in
in NHA hospitals nearby
HOSPITAL NHA HEM
HEM Catered to flood victims

24
6. Jharkhand

District Wise Utilisation and State Wise Details

Distribution of Cases by Public and Private:

25
Speciality Wise Distribution of All Hospitals and Private only:

Highest Utilized Private Hospitals:

Count
Number NABH Plausible reason for Action taken
Sl.No Hospital Name of
of beds Status high utilization (if any)
cases
Hospital conducts
medical camps. 90% Under
BHARATI Not available
1 52 6,632 cataract utilization. process by
HOSPITAL in NHA HEM
Audit revealed SHA
instances of abuse
Large number of
BRAHMANANADA
beds; High patient
NARAYANA Not available
2 200 6,286 footfall
MULTISPECIALITY in NHA HEM
Audit finds were
HOSPITAL
satisfactory
Large number of
CURIE ABDUR
beds; High patient Show Cause
RAZZAQUE ANSARI Not available
3 100 5,006 footfall Notice
CANCER in NHA HEM
Audit revealed Issued
INSTITUTE
instances of abuse
Under
NAYANDEEP EYE Not available Hospital conducts
4 20 3,898 process by
HOSPITAL in NHA HEM medical camps
SHA

26
 Audit revealed
instances of fraud
Large number of
HZB AROGYAM beds; High patient
Not available
5 MULTISPECIALITY 120 3,823 footfall;
in NHA HEM
HOSPITAL Investigation Under
process
Large number of
beds; High patient Show Cause
SINGHPUR Not available
6 95 3,259 footfall Notice
NURSING HOME in NHA HEM
Audit revealed Issued
instances of abuse
KIDNEY CARE Not available High incidence of
7 12 3,042
CENTER in NHA HEM dialysis
Large number of
SHREE NARAYAN beds; High patient Under
Not available
8 MULTISPECIALITY 100 3,016 footfall process by
in NHA HEM
HOSPITAL Audit revealed SHA
instances of abuse
High risk, suspect
MEDITRINA Not available hospital
9 58 2,956
HOSPITAL in NHA HEM High incidence of
dialysis
Large number of
DEVKAMAL
beds; High patient Show Cause
HOSPITAL AND Not available
10 100 2,941 footfall Notice
RESEARCH in NHA HEM
Audit revealed Issued
CENTRE
instances of abuse

27
7. Karnataka:

District Wise Utilisation and State Wise Details:

Distribution of Cases by Public and Private:

28
Speciality Wise Distribution of All Hospitals and Private only:

Highest Utilized Private Hospitals:

Action
Sl. Number Count of Plausible reason for
Hospital Name NABH Status taken
No of beds cases high utilization
(if any)
Large number of
Not available
1 SJICR 600 5043 beds; High patient
in NHA HEM
footfall
Large number of
Not available
2 KASTURBA HOSPITAL 2,032 3377 beds; High patient
in NHA HEM
footfall
Large number of
Not available
3 SJICR MYSORE 350 2654 beds; High patient
in NHA HEM
footfall
SDM COLLEGE OF Large number of
Not available
4 MEDICAL SCIENCES 1,200 2409 beds; High patient
in NHA HEM
AND HOSPITAL footfall
NARAYANA Not
available Not available Large Hospital; High
5 HRUDAYALAYA 1991
in NHA in NHA HEM patient footfall
PRIVATEP LIMITED
HEM

29
 Large number of
YENEPOYA MEDICAL Not available
6 7,30 1770 beds; High patient
COLLEGE HOSPITAL in NHA HEM
footfall
KLES DR Large number of
Not available
7 PRABHAKAR KORE 2,000 1763 beds; High patient
in NHA HEM
HOSPITAL AND MRC footfall
FATHER MULLER Large number of
Not available
8 MEDICAL COLLEGE 1200 1613 beds; High patient
in NHA HEM
HOSPITAL footfall
KERUDI Not Cancer Hospital/
HEALTHCARE available Not available Institute ; High
9 1408
PRIVATEP LIMITED in NHA in NHA HEM incidence of
BAGALKOT HEM Chemotherapy
Large number of
Not available
10 SIGMA HOSPITAL 75 1344 beds; High patient
in NHA HEM
footfall

30
8. Uttar Pradesh

District Wise Utilisation and State Wise Details:

Distribution of Cases by Public and Private:

31
Speciality Wise Distribution of All Hospitals and Private only:

Highest Utilized Private Hospitals:

Action
Count
Number NABH Plausible reason for high taken
Sl.No Hospital Name of
of beds Status utilization (if
cases
any)

Not
SATISH CHANDRA
available High number of Beds; High
1 PANDEY MEMORIAL 300 2,958
in NHA patient footfall
HOSPITAL PVT.LTD
HEM

Not
HERITAGE INSTITUTE OF available High number of Beds; High
2 700 2,351
MEDICAL SCIENCES in NHA patient footfall
HEM

PUSHPANJALI HOSPITAL
NABH- High number of Beds; High
3 & RESEARCH CENTRE 195 1,910
ENTRY patient footfall
PVT. LTD

32
 Not
available High number of Beds; High
4 SAI HOSPITAL 100 1,792
in NHA patient footfall
HEM

SHRI RAM MURTI

NABH- High number of Beds; High
5 SMARAK INSTITUTE OF 950 1,481
ENTRY patient footfall
MEDICAL SCIENCES

Not
HIND INSTITUTE OF available High number of Beds; High
6 700 1,427
MEDICAL SCIENCES in NHA patient footfall
HEM

Not Show
Suspect hospital; Audit
available cause
7 OPAL HOSPITAL PVT LTD 75 1,232 revealed instances of
in NHA Notice
abuse
HEM issued

Not
available High number of Beds; High
8 SHRINATH MEDICITY 95 1,142
in NHA patient footfall
HEM

SRI GORACHCHA NATH Not

CHIKITSALYA NIRMAN available High number of Beds; High
9 300 1,022
AVAM VYAWASTHAPIKA in NHA patient footfall
SAMITI HEM

Not Show
available High number of Beds; High cause
10 COSMOS HOSPITAL 120 1,016
in NHA patient footfall Notice
HEM issued

33
9. Madhya Pradesh:

District Wise Utilisation and State Wise Details:

Distribution of Cases by Public and Private:

34
Speciality Wise Distribution of All Hospitals and Private only:

Highest Utilized Private Hospitals:

Numb Count Plausible reason Action

Sl. NABH
Hospital Name er of of for high taken (if
No Status
beds cases utilization any)
Large number of
1 CITYHOSPITAL2008 250 5,139 NABH beds; High patient
footfall
CHIRAYU MEDICAL COLLEGE AND Large number of
2 HOSPITAL AUNIT OF CHIRAYU 912 4,986 NABH beds; High patient
CHARITABLE FOUNDATION footfall
Not Large number of
SRI AUROBINDO INSTITUTE OF available
3 1000 3,470 beds; High patient
MEDICAL SCIENCES in NHA
footfall
HEM
JAWAHARLAL NEHRU CANCER Cancer Hospital,
4 HOSPITAL AND RESEARCH 100 2,532 NABH High patient
CENTRE footfall
Large number of
VINDHYA HOSPITAL AND NABH-
5 100 1,978 beds; High patient
RESEARCH CENTRE ENTRY
footfall

35
 NABH- Large number of
6 SSIMS HOSPITAL 95 1,791 PREENT beds; High patient
RY footfall
Large number of
SAGARSHREE HOSPITAL AND NABH-
7 140 1,279 beds; High patient
RESEARCH INSTITUTE PVT LTD ENTRY
footfall
Large number of
8 JK HOSPITAL 760 1,276 NABH beds; High patient
footfall
Large number of
beds; High patient Under
NABH-
9 LBS HOSPITAL 100 1,249 footfall process
ENTRY
Under by SHA
investigation
Large number of
AMALTAS INSTITUTE OF MEDICAL
10 330 1,188 NABH beds; High patient
SCIENCES BANGAR DEWAS
footfall

36
10. Bihar:

District Wise Utilisation and State Wise Details:

Distribution of Cases by Public and Private:

37
Speciality Wise Distribution of All Hospitals and Private only

Highest Utilized Private Hospitals:

Count Action
Sl. Number NABH Plausible reason for
Hospital Name of taken
No. of beds Status high utilization
cases (if any)

Not
Large number of
AKHAND JYOTI EYE available
1 175 2,096 beds; High patient
HOSPITAL in NHA
footfall
HEM

Not
MAHAVIR CANCER Large number of
available
2 INSTITUTE & RESEARCH 534 2,061 beds; High patient
in NHA
CENTER footfall
HEM

Large number of
Not beds; High patient
PRASHANT MEMORIAL available footfall
3 125 1,988
CHARITABLE HOSPITAL in NHA
HEM Audit revealed
satisfactory findings

38
 Not
Large number of
NARAYAN MEDICAL available
4 750 1,802 beds; High patient
COLLEGE AND HOSPITAL in NHA
footfall
HEM

Not
Large number of
M.G.M. MEDICAL COLLEGE & available
5 650 1,798 beds; High patient
L.S.K. HOSPITAL in NHA
footfall
HEM

Not
NAVJIVAN MULTISPECIALITY
available High utilization of
6 HOSPTAL & REASERCH 50 627
in NHA Hemodialysis
CENTRE PVT LTD
HEM

Not
High incidence of
YOGMAYA DEVI MEMORIAL available
7 20 602 Cataract surgery
HOSPITAL in NHA
using SICS
HEM

Large number of
Not beds; High patient
available footfall
8 ASHOKA HOSPITAL 100 477
in NHA
HEM Audit revealed
satisfactory findings

Not
Large number of
available
9 CRIBS HOSPITAL 150 427 beds; High patient
in NHA
footfall
HEM

Not
JAHNAVI EYE CARE AND available High incidence of
10 22 398
RESEARCH CENTRE in NHA cataract
HEM

39
11. Uttarakhand

District Wise Utilisation and State Wise Details:

Speciality Wise Distribution of All Hospitals and Private only

40
Speciality Wise Distribution of All Hospitals and Private only:

Highest Utilized Private Hospitals:

Count Action
Sl. Number NABH Plausible reason for high taken
Hospital Name of
No of beds Status utilization
cases (if any)

Not
SWAMI RAMA
available High number of Beds; High
1 HIMALAYAN 1171 13,551
in NHA patient footfall
UNIVERSITY
HEM

Not High number of Beds; High

available patient footfall
SHRI MAHANT in NHA Penalty
2 1000 7,040 Audits revealed
INDIRESH HOSPITAL HEM levied
satisfactory result with
some aberrations

Not Show
Large number of beds,
M P MEMORIAL available Cause
3 86 2,808 investigation under
HOSPITAL in NHA Notice
progress
HEM issued

41
 Not High number of Beds; High
available patient footfall Under
4 KALINDI HOSPITAL 100 2,167 in NHA process
HEM Audits revealed by SHA
aberrations

Not Show
available Audit revealed incidents of Cause
5 RAHI CARE PVT LTD 12 2,105
in NHA abuse Notice
HEM issued

Not
Under
available Suspected high risk
6 PREMSUKH HOSPITAL 30 1,562 process
in NHA hospital
by SHA
HEM

METRO HOSPITAL AND High number of Beds; High

7 394 1,130 NABH
HEART INSTITUTE patient footfall

Not
JAGDAMBA TRAUMA available High number of Beds; High
8 100 876
CENTRE in NHA patient footfall
HEM

Not
SHRI SWAMI available High number of Beds; High
9 150 818
BHUMANAND HOSPITAL in NHA patient footfall
HEM

Not
NEPHROCARE HEALTH available
10 23 615 High incidence of Dialysis
SERVICES PVT LTD in NHA
HEM

42
12. Assam:

District Wise Utilisation and State Wise Details:

Distribution of Cases by Public and Private only:

43
Speciality Wise Distribution of All Hospitals and Private only:

Highest Utilized Private Hospitals:

Count Action
Sl. Number NABH Plausible reason for
Hospital Name of taken (if
No of beds Status high utilization
cases any)

NARAYANA
Large number of beds;
1 SUPERSPECIALITY 162 2,793 NABH
High patient footfall
HOSPITAL

Not
available Large number of beds;
2 EXCELCARE HOSPITALS 176 2,671
in NHA High patient footfall
HEM

Not
CHANDRAPRABHA EYE available High incidence of
3 30 1,745
HOSPITAL in NHA cataract
HEM

CACHAR CANCER Not

High number of beds ,
4 HOSPITAL AND 152 1,365 available
Cancer Care
RESEARCH CENTRE

44
 in NHA
HEM

Not
J.J. MEMORIAL
available Large number of beds;
5 DIAGNOSTICS & 100 1,175
in NHA High patient footfall
HOSPITALS PVT LTD
HEM

Not
GNRC INSTITUTE OF
available Large number of beds;
6 MEDICAL SCIENCES, 303 1,140
in NHA High patient footfall
AMINGAON
HEM

Not
HAMM HOSPITAL & available High utilization of Lap To be
7 30 879
RESEARCH CENTRE in NHA Cholecystectomy investigated
HEM

Not
H.M POLYCLINIC & available High utilization of
8 55 650
DIAGNOSTIC CENTRE in NHA Haemodialysis
HEM

Not
available Large number of beds;
9 ARYA HOSPITAL 100 632
in NHA High patient footfall
HEM

DISPUR HOSPITALS PVT NABH- Large number of beds;

10 155 621
LTD ENTRY High patient footfall

45
13. Meghalaya

District Wise Utilisation and State Wise Details:

Distribution of Cases by Public and Private:

46
Speciality Wise Distribution of All Hospitals and Private only

Highest Utilized Private Hospitals:

Count Action
Number of NABH Plausible reason for
Sl.No Hospital Name of taken (if
beds Status high utilization
cases any)

Not
Not High incidence of
NAZARETH available
1 available in 7,810 conservative
HOSPITAL in NHA
NHA HEM management cases
HEM

Not
Not High incidences of
available
2 BETHANY HOSPITAL available in 3,392 normal delivery and
in NHA
NHA HEM animal bite
HEM

Not High incidence of

Not
SUPERCARE available conservative
3 available in 1,898
HOSPITAL in NHA management cases
NHA HEM
HEM and haemodialysis

47
 Large number of
WOODLAND NABH-
4 166 1,841 beds; High patient
HOSPITAL ENTRY
footfall

Not High incidence of

Not
DR.H GORDON available conservative
5 available in 1,628
ROBERT HOSPITAL in NHA management cases
NHA HEM
HEM and haemodialysis

Not
Not High incidence of
HOLY CROSS available
6 available in 1,038 conservative
MAIRANG in NHA
NHA HEM management cases
HEM

Not
Not High incidence of
BETHANY available
7 available in 989 conservative
OUTREACH in NHA
NHA HEM management cases
HEM

Not
Not High incidence of
HOLY CROSS TURA available
8 available in 834 conservative
HOSPITAL in NHA
NHA HEM management cases
HEM

Not
Not
BANSARA EYE available High incidence of
9 available in 430
CARE HOSPITAL in NHA cataract
NHA HEM
HEM

Not
Not High incidence of
THE CHILDREN available
10 available in 374 conservative
HOSPITAL in NHA
NHA HEM management cases
HEM

48
14. Haryana:

District Wise Utilisation and State Wise Details:

Distribution of Cases by Public and Private:

49
Speciality Wise Distribution of All Hospitals and Private only:

Highest Utilized Private Hospitals:

Count Action
Number NABH Plausible reason for high
SI.No Hospital Name of taken
of beds Status utilization
cases (if any)
Large number of beds; High
ENTRY patient footfall
1 GABA HOSPITAL 100 2,353
LEVEL Audit revealed satisfactory
findings
Not
KURUKSHETRA available Under
2 67 1,718 Audit revealed aberrations process
NURSING HOME in NHA
by SHA
HEM

Large number of beds; High

3 VIRAT HOSPITALS 100 916 NABH
patient footfall

SIDHARTH
4 48 852 NABH High incidence of haemodialysis
HOSPITAL

MANN
5 MULTISPECIALITY 50 741 NABH High incidence of haemodialysis
HOSPITAL

50
 CYGNUS
Large number of beds; High
6 SUPERSPECIALITY 100 690 NABH
patient footfall
HOSPITAL
SAPRA NABH-
Large number of beds; High
7 MULTISPECIALITY 110 687 PRE-
patient footfall
HOSPITAL ENTRY

SANJIVANI ENTRY Large number of beds; High

8 100 674
HOSPITAL LEVEL patient footfall

Not
SARASWATI
available
9 MISSION 86 584 High incidence of cataract cases
in NHA
HOSPITAL
HEM
BS HEART CARE Not
AND available
10 30 645 High incidence of haemodialysis
MULTISPECIALITY in NHA
HOSPITAL HEM

51
15. Jammu & Kashmir

District Wise Utilisation and State Wise Details

Distribution of Cases by Public and Private:

52
Speciality Wise Distribution of All Hospitals and Private only:

Highest Utilized Private Hospitals:

Number of Count of NABH Plausible reason Action taken

SI.No Hospital Name
beds cases Status for high utilization (if any)
KHYBER Not
available
1 MEDICAL 50 4,961 High patient footfall
in NHA
INSTITUTE
HEM
Not Large number of
NOORA available
2 100 2,717 beds; High patient
HOSPITAL in NHA
footfall
HEM
AL IMDAAD Not
available High incidence of
3 DIALYSIS 8 1,841
in NHA dialysis
CENTRE
HEM
JAMMU CITY Not
ONCOLOGY available High incidence of
4 14 1,434 in NHA
CLINIC WITH dialysis
INTERVENTIONS HEM
Not
IBN SINA available Audit revealed Penalty
5 39 1,126
HOSPITAL in NHA instances of abuse levied
HEM

53
 ILLAHIYA Not
available High incidence of
6 DIALYSIS 11 949
in NHA haemodialysis cases
CENTER
HEM
WELL CARE Not
available High incidence of
7 DIALYSIS 10 659
in NHA haemodialysis cases
CENTRE
HEM
LORDS HOSPITAL Not
available High incidence of
8 AND DIAGNOSTIC 15 639
in NHA haemodialysis cases
CENTRE
HEM
Not
NATIONAL available High incidence of
9 18 480
HOSPITAL in NHA haemodialysis cases
HEM
AL HUDA RENAL Not
CARE AND available High incidence of
10 5 442 in NHA
DIALYSIS haemodialysis cases
CENTRE HEM

54
16. Tripura

District Wise Utilisation and State Wise Details

Distribution of Cases by Public and Private:

55
Speciality Wise Distribution of All Hospitals and Private:

56
17. Himachal Pradesh

District Wise Utilisation and State Wise Details

Distribution of Cases by Public and Private:

57
Speciality Wise Distribution of All Hospitals and Private:

Highest Utilized Private Hospitals:

Action
Number of Count of NABH Plausible reason
SI.No Hospital Name taken (if
beds cases Status for high utilization
any)

Not
Not Appears suspect
available To be
1 SURYA HOSPITAL available in 488
in NHA hospital investigated
NHA HEM
HEM
Not
SAI SANJEVANI Not Appears suspect
available To be
2 available in 336
HOSPITAL SOLAN in NHA hospital investigated
NHA HEM
HEM
Not
KARAN HOSPITAL Not Appears suspect
available To be
3 available in 311
PALAMPUR in NHA hospital investigated
NHA HEM
HEM
M.M. MEDICAL Not Large number of
available
4 COLLEGE & 720 296 beds; high patient
in NHA
HOSPITAL footfall
HEM

58
 MMS ROTARY EYE Not Large number of
available
5 HOSPITAL 100 231 beds; high patient
in NHA
MARANDA footfall
HEM
Not High incidence of
available
LORD MAHAVIR Not UTI &
in NHA To be
6 HOSPITAL available in 227 gastroenteritis;
HEM investigated
NALAGARH NHA HEM appears suspect
hospital

MALHOTRA Not Large number of

available
7 SUPERSPECAILITY 100 196 beds; high patient
in NHA
HOSPITAL footfall
HEM
SHRI SAI Not
available High incidence of
MULTISPECIALITY
8 50 163 in NHA haemodialysis
HOSPITAL AND
HEM cases
TRAUMA CENTRE
Not
SOOD NURSING Not available High incidence of To be
9 HOME NAGROTA available in 156 in NHA
pancreatitis cases investigated
BAGWAN NHA HEM HEM

Not High incidence of

PARVATI available
10 30 120 haemodialysis
HOSPITAL in NHA
cases
HEM

59
18. Mizoram:

District Wise Utilisation and State Wise Details

Distribution of Cases by Public and Private:

60
Speciality Wise Distribution of All Hospitals and Private:

Highest Utilized Private Hospitals:

Action
Count
Number of NABH Plausible reason for taken
SI.No Hospital Name of
beds Status high utilization (if
cases
any)

Not Not
MEDAIM ADVENTIST available Big Hospital; High
1 available in 319
HOSPITAL in NHA incidence
NHA HEM
HEM
Not Not
LCMC HOSPITAL available High incidence of UTI
2 available in 282
LAWNGTLAI in NHA cases
NHA HEM
HEM
Not Not
EYE CARE High incidence of
3 available in available
COMMUNITY 124 cataract
NHA HEM in NHA
RESEARCH CENTRE
HEM

61
19. Andhra Pradesh:

District Wise Utilisation and State Wise Details (Limited data as available)

Distribution of Cases by Public and Private:

62
Speciality Wise Distribution of All Hospitals and Private:

Highest Utilized Private Hospitals:

Plausible Action
Sl Number Count of NABH
Hospital Name reason for high taken (if
No of beds cases Status
utilization any)
Not Medical College;
Not available High patient
NARAYANA
available in NHA footfall ; Penalty
1 MEDICAL COLLEGE 160
in NHA HEM Audit revealed levied
HOSPITAL
HEM instances of
abuse
OMEGA HOSPITALS Not Not Cancer Institute;
A UNIT OF KURNOOL available available High incidence
2 142
INSTITUTE OF in NHA in NHA of
ONCOLOGY PVT LTD HEM HEM Chemotherapy
MS MAHATMA Not
Not Cancer Institute;
GANDHI CANCER available
available High incidence
3 HOSPITAL AND 135 in NHA
in NHA of
RESEARCH HEM
HEM Chemotherapy
INSTITUTE

63
 KRISHNA INSTITUTE Not
Not
OF MEDICAL available Large number of
available
4 SCIENCES 130 in NHA beds; High
in NHA
BOLLINENI HEM patient footfall
HEM
HOSPITAL NELLORE
AMERICAN Not Not Cancer Institute;
ONCOLOGY available available High incidence
5 97
INSTITUTE A UNIT in NHA in NHA of
OF CTSI HEM HEM Chemotherapy
SURYA GLOBAL Not
Not Cancer institute;
MULTI SPECIALITY available
available Audit revealed Penalty
6 HOSPITALS AND 95 in NHA
in NHA instances of levied
CANCER RESEARCH HEM
HEM abuse
CENTRE
Not Not
LALITHA SUPER Large number of
available available
7 SPECIALITY 92 beds; High
in NHA in NHA
HOSPITAL P LTD patient footfall
HEM HEM
Not Not Cancer Institute;
HCG PINNACLE available available High incidence
8 87
CANCER CENTRE in NHA in NHA of
HEM HEM Chemotherapy
Not Not
Large number of
QUEENS NRI available available
9 83 beds; High
HOSPITALS in NHA in NHA
patient footfall
HEM HEM
Not Not Cancer Institute;
GOOD SAMARITAN
available available High incidence
10 CANCER AND 82
in NHA in NHA of
GENERAL HOSPITAL
HEM HEM Chemotherapy

64
20. Manipur:

District Wise Utilisation and State Wise Details

Distribution of Cases by Public and Private:

65
Speciality Wise Distribution of All Hospitals and Private:

Highest Utilized Private Hospitals:

Sl. Hospital Name Number Count NABH Plausible reason for high Action
No of beds of Status utilization taken (if
cases any)

1 SHIJA HOSPITALS 250 1160 NABH- High number of Beds; High

AND RESEARCH ENTRY patient footfall
INSTITUTE

2 RAJ MEDICITY 200 197 Not High number of Beds; High

available patient footfall
in NHA
HEM

3 SKY HOSPITAL & 100 33 Not High number of Beds; High

RESEARCH CENTRE available patient footfall
PVT LTD in NHA
HEM

4 ADVANCED 100 22 Not High number of Beds; High

SPECIALITY HOSPITAL available patient footfall
& RESEARCH in NHA
INSTITUTE HEM

66
21. Chandigarh:

District Wise Utilisation and State Wise Details

Distribution of Cases by Public and Private:

67
Speciality Wise Distribution of All Hospitals and Private

Highest Utilized Private Hospitals:

Action
Number of Count of NABH Plausible reason for
SI.No Hospital Name taken (if
beds cases Status high utilization
any)
Not High incidence of
SANTOKH available haemodialysis cases
1 35 1,088
HOSPITAL in NHA Audit findings were
HEM satisfactory
Not
DHARAM available High incidence of
2 21 213
HOSPITAL in NHA haemodialysis cases
HEM
EDEN CRITICAL Not Large number of
available
3 CARE HOSPITAL 100 66 beds; high patient
in NHA
LTD footfall
HEM
DABUR Not
available High incidence of
4 DHANWANTRY 40 29
in NHA haemodialysis cases
HOSPITAL
HEM

68
22. Nagaland:

District Wise Utilisation and State Wise Details

Distribution of Cases by Public and Private:

69
Speciality Wise Distribution of All Hospitals and Private:

Highest Utilized Private Hospitals:

SI.No Hospital Name Number Count NABH Plausible reason for Action
of beds of Status high utilization taken (if
cases any)

1 CHRISTIAN INSTITUTE Not 424 Not High incidence of

OF HEALTH SCIENCES available available haemodialysis cases
RESEARCH in NHA in NHA
HEM HEM

2 FAITH HOSPITAL Not 361 Not High risk suspect

available available hospital
in NHA in NHA
HEM HEM

3 HOUSE OF HOPE Not 154 Not High incidence of Acute

available available febrile illness and
in NHA in NHA Enteric fever
HEM HEM

70
23. Punjab

District Wise Utilisation and State Wise Details

Distribution of Cases by Public and Private:

71
Speciality Wise Distribution of All Hospitals and Private:

Highest Utilized Private Hospitals:

Sl.No Hospital Name Number Count NABH Plausible reason for Action
of beds of Status high utilization taken
cases (if any)

1 DELHI HEART 105 72 NABH High number of Beds;

INSTITUTE & High patient footfall
MULTISPECIALITY
HOSPITAL

2 PUNJAB CANCER CARE 25 48 Not Cancer

& RESEARCH CENTRE available Hospital/Institute; High
in NHA number of
HEM Chemotherapy

3 RAJAN HOSPITAL & 35 46 NABH- High incidence of

HEART CENTRE ENTRY conservative
management

72
List of Abbreviations/ special terminology used:

1. AB PMJAY- Ayushman Bharat Pradhan Mantri Jan Arogya Yojana

2. NHA - National Health Agency

3. Cr - Crore

4. L- Lakh

5. HEM- Hospital Empanelment System

6. NAFU - National Anti-Fraud Unit

7. SAFU - State Anti-Fraud Unit

8. SHA - State Health Agency

9. TMS - Transaction Management System

10. UTs - Union Territories

73
74