In a move that will ensure cashless treatment and faster claim settlements at all civic-run medical facilities, the Brihanmumbai Municipal Corporation (BMC) has proposed an Integrated Patient's Healthcare Schemes Assistance (IPHSA) system and the civic body has floated a tender for the system, currently in the planning stage. “The IPHSA System is a landmark initiative that will strengthen public trust in BMC’s healthcare network. Once operational, it will ensure cashless treatment and faster claim settlements, benefiting both patients and hospitals,” a senior BMC health official said. The IPHSA platform is expected to serve as a single-window system to streamline access to government health schemes and financial assistance programmes, including Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY), Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), Employees’ State Insurance Corporation (ESIC), Rajiv Aarogyasri (RAN), and the Health Minister’s Discretionary Fund (HMDF). According to civic officials, the system has been designed to reduce delays, eliminate paperwork, and minimise out-of-pocket expenses for patients. Hospitals under BMC are expected to benefit from higher claim realisation, reduced administrative workload, and improved financial sustainability once the system is implemented. The project is planned to be implemented in four zones. Zone 1 would include KEM, Kasturba, ENT, Eye, TB, and Leprosy hospitals. Zone 2 would cover Nair Medical College, Nair Dental, and Western Peripheral hospitals. Zone 3 would include LTMG Medical College, the Thalassemia Centre, and Eastern Peripheral hospitals, while Zone 4 would bring Cooper Medical College, Trauma Centre, maternity homes, dispensaries, Aapla Dawakhana, HBT Polyclinics, and Shiv Yoga Centres under the framework. To enable seamless operations, the platform is expected to integrate with Hospital Management Information Systems (HMIS) and external government scheme portals. Patients would be identified, their eligibility verified, treatment authorised, and claims processed digitally. A mobile app and progressive web app are planned to provide real-time updates for patients and hospitals. Accountability would be maintained through structured reporting on daily, weekly, monthly, and quarterly bases. The service provider will be evaluated under the Quality-Based Selection (QBS) model, which prioritizes outcomes over lowest-cost contracts. The contract for the initiative is proposed for five years, initially two years, with a possible three-year extension based on performance. The selected service provider will be remunerated through a commission of three to five percent of total claim settlements. BMC expects IPHSA, once operational, to transform municipal healthcare delivery into a patient-friendly and financially sustainable ecosystem, making equitable and cashless treatment accessible to all citizens.
