Long, winding road towards DRG payment model rollout


KUALA LUMPUR: A proper rollout of the diagnosis-related group (DRG) payment model could take more than six months, given the complexities in data gathering and analysis, said Association of Private Hospitals Malaysia (APHM) president Datuk Dr Kuljit Singh. 

He said that for any DRG or any DRG-type mechanism to work, accurate clinical data and a national electronic health record system are needed. 

Presently, this foundational data is not yet available, which presents significant challenges for timely and effective DRG implementation, he added. 

“As the process of gathering and analysing such data is complex and time-consuming, APHM anticipates that a proper rollout will require considerably more than six months,” said Dr Kuljit. 

He also said the APHM is heartened to hear Health Minister Datuk Seri Dr Dzulkefly Ahmad’s announcement at the APHM International Healthcare Conference and Exhibition 2025 that a basic medical and health insurance/takaful (MHIT) product will be introduced later this year, while the DRG will be rolled out in phases. 

To support this national initiative, Dr Kuljit said APHM member hospitals have offered to share relevant clinical data required for the set-up of a DRG system with the Health Ministry and the Finance Ministry. 

“APHM strongly advocates that adequate time and resources be allocated to ensure that the DRG initiative is thoroughly conceptualised, piloted and implemented to ultimately deliver sustainable improvements for all Malaysians,” added Dr Kuljit. 

Earlier, Dzulkefly said introducing DRGs to pay for healthcare services, in phases, beginning with MHIT products, will be a key driver for value-based healthcare. 

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