PETALING JAYA: Malaysia’s healthcare system must prioritise better patient outcomes over treatment volume and ensure long-term cost sustainability, says Health Minister Datuk Seri Dr Dzulkefly Ahmad.
The minister said this shift towards value-based healthcare could be seen in government initiatives, including the Malaysia Digital Health Certification Network and the upcoming MediAsas, which will undergo pilot testing soon at selected private hospitals.
“We need to find the value in improving health outcomes and patient experience while ensuring value in every ringgit spent by patients on healthcare,” he said during the launch of the 32nd Association of Private Hospitals Malaysia (APHM) International Healthcare Conference and Exhibition here yesterday.
“It is about prioritising preventive care, minimising unnecessary hospital readmissions and prolonged admissions, and ensuring that every clinical intervention improves a person’s long-term quality of life,” said Dzulkefly, who noted that medical inflation in the private sector has been reported at around 15%.
“In the first half of 2024 alone, about 340,000 policyholders surrendered their medical insurance policies.
“This represents hundreds of thousands of Malaysians losing their crucial financial safety net when they are at their most vulnerable,” Dzulkefly said, noting that the Public Accounts Committee had warned of a potential domino effect on public hospitals.
He added that the Joint Ministerial Committee on Private Healthcare Costs (JBMKKS), which he co‑chairs with Finance Minister II Datuk Seri Amir Hamzah Azizan, is accelerating reforms under the RESET Strategy, which includes the launch of MediAsas.
“With indicative premiums structured as low as RM60, MediAsas provides an affordable, essential safety net to bring underinsured Malaysians back into private care.
“To ensure long-term stability and safeguard consumer interests, JBMKKS is also establishing an independent governance board to maintain oversight over the plan’s execution.
“Private hospitals have also shared clinical and financial data to help design the Diagnosis‑Related Groups (DRG) payment system that supports MediAsas,” said Dzulkefly, who added JBMKKS and APHM are finalising a standardised framework for hospital bill presentation this year.
On MediAsas, APHM president Datuk Dr Kuljit Singh said APHM has given the Health Ministry all the facts for the operational part.
ProtectHealth Corporation (PH Corp), which comes under the Health Ministry, will brief the hospitals on the implementation of the pilot project.
“So the details are with PH Corp, along with the hospitals participating in the pilot project,” he said in a separate interview with The Star.
When asked if the selected private hospitals will be concerned about premium adjustments, he said APHM’s priority is to make MediAsas realistic and also sustainable for patients, healthcare providers, and the payers.
“Any implementation has to be a win-win situation for all parties. The payer must be able to sustain the programme; healthcare providers must be able to treat patients based on the claims allowed; and patients must receive value for the premiums they have paid, because premiums can vary in MediAsas.
“This ensures patients can continue their treatment without interruption midway.
“We have to run the pilot test to know whether the quantum and the amounts for claims are good enough to cover the conditions,” he said.
On DRG, Kuljit said that APHM is already sharing DRG data with the authorities but stressed the need for a phased rollout with proper testing and capacity building, while warning that a plug‑and‑play approach would not work.
“We need continuous engagement to identify the gaps, understand where DRG works well and where it does not, and determine whether it should be applied across all services or only in selected areas.”
