Mumbai News: KEM Hospital Receives ‘Vandaniya Balasaheb Thackeray Jan Aarogya Gaurav Puraskar’ For Best Implementation Of Govt Insurance Schemes

Mumbai: Mumbai’s civic-run KEM Hospital has been awarded this year’s “Vandaniya Balasaheb Thackeray Jan Aarogya Gaurav Puraskar.” The honour recognises KEM as the best-performing hospital in Mumbai for the effective and successful implementation of the Mahatma Jyotirao Phule Jan Arogya Yojana and the Ayushman Bharat–Pradhan Mantri Jan Arogya Yojana.

How the Initiative Began in 2015

To ensure that poor patients in civic hospitals are not deprived of their rightful access to free treatment, Minister Ashish Shelar initiated efforts in 2015 and placed his trust in the ‘End-to-End Claim Management’ concept developed by Vikas Deshmukh of Creative Solutions. Deshmukh spent nearly four years explaining the model to municipal officials, but it was not taken seriously at first.

Eventually, Minister Shelar personally facilitated meetings with deputy commissioners and municipal commissioners, enabling Deshmukh to present the model. Shelar kept the initiative under constant follow-up, leading to the issuance of the first tender in 2016.

Minister Shelar Calls Award a Victory for Poor Patients

Shelar said, “This award is not just for KEM Hospital—it is a victory reflected in the satisfaction and smiles on the faces of Mumbai’s underprivileged patients.”

Model Implemented Across All Major BMC Hospitals

On 1 January 2018, Creative Solutions began implementing the model across all major hospitals of the Brihanmumbai Municipal Corporation (BMC), yielding highly positive outcomes. Patients across municipal hospitals started receiving 100% coverage under government health insurance schemes, and claims worth an average of Rs 84 crore were successfully processed every year.

Due to Minister Shelar’s intervention and Deshmukh’s performance-based model, lakhs of poor patients in Mumbai today are benefiting from free, government-funded healthcare worth crores of rupees.

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Financial Setbacks Faced Between 2012 and 2017

Between 2012 and 2017, however, BMC hospitals suffered major financial setbacks. More than Rs 50 crore worth of claims were rejected due to lack of trained staff and administrative lapses in processing government health scheme claims. This not only caused significant financial loss to the corporation but also deprived poor patients of their right to free medical treatment.

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