Operational implementation of the Ayushman Vay Vandana Card: A novel framework for enhancing senior healthcare access in India

Objectives

• 1.

  To evaluate the enrollment and demographic distribution of AVVC beneficiaries.

• 2.

  To describe the operational workflow and hospital network involved in service delivery.

• 3.

  To assess healthcare utilization and financial impact among enrolled senior citizens.

• 4.

  To provide evidence-based insights for policymakers to enhance senior healthcare programs.

Study design

This program evaluation analyzed administrative and programmatic data from the AVVC initiative up to October 2025. It employs a descriptive implementation analysis rather than a traditional observational study, focusing on secondary data to assess program reach, utilization, and impact. Data sources included the Ayushman Bharat portal (primary enrollment and beneficiary database), mobile application records (real-time registration logs), and empaneled hospital reports (treatment authorization claims). Data validation involved cross-checking records across sources for consistency (e.g., matching Aadhaar numbers), completeness checks (removing records with >20% missing fields), and deduplication using unique beneficiary IDs. Approximately 2% of records were excluded due to duplicates or incompleteness [Figure 1].

Close

Figure 1:

Workflow of enrollment to service utilization. (High-resolution flowchart to show Aadhaar-based registration, card issuance, hospital visits, and treatment utilization).

Export to PPT

Eligibility criteria

• 1.

  Beneficiaries aged 70 years and above.

• 2.

  Enrollment via online portal, mobile app, or offline registration at empaneled hospitals.

Exclusions: Incomplete records (e.g., missing Aadhaar verification) or inactive cards (no utilization within 6 months post-issuance, n = 1.2 lakh records flagged but retained for enrollment analysis).

Enrollment process

• 1.

  Aadhaar-based e-KYC for identity verification.

• 2.

  Multiple registration channels: online portal, mobile app, empaneled hospitals, and toll-free helpline.

• 3.

  Immediate issuance of AVVC to eligible seniors, irrespective of socio-economic status.

Healthcare coverage

• 1.

  Up to ₹5 lakh annual coverage per senior citizen.

• 2.

  Coverage includes ∼2,000 medical procedures, including pre-existing conditions with no waiting period.

• 3.

  Services delivered by over 33,000 empaneled hospitals (public and private).

Data analysis

Descriptive statistics summarized enrollment, hospital participation, treatment utilization, and financial outcomes. Key outcomes were operationally defined as: (i) Healthcare utilization (number of authorized hospital admissions and procedures per beneficiary); (ii) Financial impact (total treatment value availed in ₹ crore, out-of-pocket savings estimated at 100% coverage for eligible claims); (iii) Beneficiary impact (case studies from anonymized hospital feedback forms, n = 50, assessing access barriers pre/post-AVVC). Figures, tables, and charts visualized program impact.

Ethical consideration

• 1.

  Approved by the Institutional Ethics Committee (IEC), Protocol No. IEC/2024/AVVC-01, dated 15 November 2024.

• 2.

  Waiver of informed consent granted for secondary administrative data analysis, as no primary participant interaction occurred; individual identifiers were anonymized using aggregation at the state level.

• 3.

  Patient identifiers were anonymized for reporting purposes.

Enrollment and demographics

• 1.

  Enrollment reached 25 lakh seniors within 2 months of launch in late 2024.

• 2.

  By October 2025, 86.51 lakh senior citizens received AVVCs.

• 3.

  Gender distribution ∼50% male, 50% female.

• 4.

  Age distribution focused on citizens aged ≥70 years. The enrollment and demographic distribution are presented in Table 1, and hospital network details are shown in Table 2.

Hospital network

• 1.

  33,000+ hospitals empaneled nationwide, including 17,685 public and 15,380 private providers.

  Hospitals are distributed regionally to ensure accessibility [Table 2].

• 2.

  The enrollment and demographic distribution are presented in Table 1, and hospital network details are shown in Table 2.

Healthcare utilization

• 1.

  By December 2024, treatments worth ₹40 crore were availed by 22,000 senior citizens.

• 2.

  By early 2025, 8.59 crore hospital admissions worth ₹1.19 lakh crore will be authorized under AB PM-JAY, including AVVC.

• 3.

  By July 2025, hospital admissions authorized exceeded 9.84 crore, with a total treatment value of ₹1.40 lakh crore.

Beneficiary impact and satisfaction

• Improved healthcare access reported in beneficiary case studies (n = 50, sourced from hospital feedback; 92% reported reduced travel barriers).

• Reduced financial burden for senior citizens (estimated savings: ₹40 crore in the 1^st months).

• Short-term benefits: over ₹40 crore utilized within months of launch.