Under this new policy, the services in Government hospitals are provided free to patients, but necessary infrastructure was lacking. To provide better radiology services in all health care facilities operated by State Health Societies in 38 districts, these services were contracted to private providers who would set up and operate the necessary infrastructure in the allotted space inside the health center as per agreement, and would be paid charges as per rates fixed by State Health Society Bihar for the number of tests performed.
Expression of interest was invited from various private providers operating similar services and the providers were selected through a process of technical evaluation. The partnership was formalized through a signed Memorandum of Understanding (MoU) and rates were fixed at which the charges would be reimbursed. Initially, the charges were paid by users (patients). However, when the decision was taken to provide free treatment to all patients coming to government hospitals, the MoU was amended and the charges were being paid by the Government.
X rays are provided in all hospitals; ultrasound units and HSG facility is provided in Sub District hospitals. X Ray films are generated by the private provider, and are reported by doctors in government hospital. A Central Reporting System is being established as part of the next phase in Patna and is connected with all ultrasound and X ray centers set up in government hospitals. With help of Tele-radiology, reporting is done from a central location in Patna by a radiologist appointed by government. The private provider is paid Rs 50 (approx. US $1) for small plate of X Ray and Rs 75 for big plate of X ray by Rogi Kalyan Samithi of the hospital. In 38 districts of Bihar, approximately 150 units are functional and have provided services to more than 150000 patients in the last four years.
IGEMS developed an innovative business model of franchising where local entrepreneurs are encouraged to operate the radiology centers with technical support from IGEMS. This models creates rural employment apart from providing radiology services at economical costs. This high volume model helps in negotiating with vendors for best prices for raw materials thus achieving economies of scale and gaining nominal profits in spite of very low costs.
Monitoring is done by district health society and payments are made from districts. Delay in payments has been biggest concern of the private providers.