India’s Ayushman Bharat PMJAY scheme has significantly expanded financial protection and inpatient access for over 500 million people. While early reforms focused on coverage expansion, empanelment, fraud control, and utilization, the next phase requires leveraging purchasing power to drive quality and outcomes. The National Health Authority’s value-based purchasing policy (2022) signals this transition, though uptake remains limited. Lessons from Indian states and international experience, particularly Thailand’s strategic purchasing reforms, demonstrate how payment design, provider engagement, audits, DRG pilots, and data-driven mechanisms can shift from passive reimbursement to outcome-oriented purchasing. As scheme operations stabilize, the opportunity now lies in using purchasing levers to incentivize quality, patient satisfaction, and efficiency.
Deliberate strategies for strengthening strategic purchasing in India.
Draw transferable lessons from Thailand’s purchasing reforms.
Identify feasible payment and incentive levers under PMJAY.
Examine institutional capabilities required for outcome-focused purchasing.
Discuss state-level experiences in linking payment to quality and performance.