THE move to shift private healthcare towards a value-based, data-driven payment system is still in its early phase, says Datuk Seri Dr Dzulkefly Ahmad (pic).
The Health Minister said the ministry’s focus is currently on collecting data for the Diagnosis Related Group (DRG) mechanism.
“At this stage, DRG implementation focuses on collecting and standardising clinical and financial data to develop the DRG algorithm or logic, as well as setting appropriate treatment ranges for each medical case,” he said.
He was replying to Rodziah Ismail (PH-Ampang), who asked for the latest status of DRG implementation in the private healthcare industry and the safeguards to prevent insurer or takaful interference in clinical decisions.
The DRG is a system that classifies and standardises hospital cases based on three main components, including diagnosis, treatment procedures and illness severity.
The system is aimed ensuring medical fees and case classification are fair, transparent and aligned with clinical needs.
Besides data collection, Dzulkefly said the current work on DRG in the private sector also involves system development, training and preparing private hospitals to operate the system.
“So far, 80 out of 104 private hospitals that have registered for DRG training and have participated in 23 training sessions organised by the Health Ministry through ProtectHealth Corporation (PH Corp),” he said.
He added that DRG is expected to support ongoing reforms to move the healthcare system towards value-based care by promoting efficiency, cost transparency and more prudent use of resources in private hospitals.
On concerns over interference by insurers, takaful operators and third-party administrators (TPAs), Dzulkefly said the ministry views the matter seriously if it inconsistent with Private Healthcare Facilities and Services Act.
He added that a grievance mechanism committee is also in place to address disputes and issues raised by stakeholders.
