Issue of medical claims inflation in Malaysia


There are several considerations to address the issue of medical claims inflation in Malaysia:

  1. Transparency of Medical Procedure Costs: There is a need to provide greater public transparency of the various costs of medical procedures. This can be achieved through the publication of reference benchmark costs for common medical procedures. This will enable patients, particularly those who are self-paying, to make well-informed decisions on their desired level of healthcare service and its associated costs.

  2. Co-payments or Deductibles in MHI Plans: The adoption of co-payments or deductibles in MHI plans can give policyholders more control over the costs of their healthcare decisions. These changes, which have also been observed in other countries such as Singapore and Australia, can have an important effect in capping the persistent increase in healthcare costs through better market discipline.

  3. Standardisation and Collection of Data: There is a need to facilitate the standardisation and collection of data that can be used by both the medical and insurance and takaful industries to increase efficiency, reduce waste, prevent fraud and improve product design. This calls for the application of a consistent diagnostic classification standard and standardised formats for billings to increase cost transparency.

  4. Digitalisation of Medical Records: The digitalisation of medical records and integration of health information systems have the potential to generate significant operational efficiencies and contribute towards moderating medical claims inflation.

These measures require coordinated actions from all stakeholders in the ecosystem for medical services in Malaysia, including payors, healthcare providers, regulators, managed care organisations, and end consumers. The Bank has issued the Guidelines on Medical and Health Insurance Business which set out minimum standards for insurers and takaful operators to promote sound underwriting and pricing practices. However, longer-term solutions to promote the sustainability of MHI protection call for deep reforms in a number of areas.

Comments

Post a Comment

Popular posts from this blog

How much money does someone need to earn in order to be "happy"

Image
The amount of income required for an individual to achieve happiness while residing in the United States varies depending on their location; however, on the whole, it appears to be significantly higher than the average annual income earned by Americans. Seems in the US, by achieving  88.8% to 111% of annual median income ($67521) are emotionally well, while 140% to 155% are enough for life satisfaction. Do you agree with this in your country?  Annual Median Income in Malaysia in 2019 is about RM85116 In 2018, a global study published in 2018   examined the amount of money that appears to bring happiness to individuals, as well as the point at which money ceases to have an effect on their well-being. Although "happiness" is a subjective concept, the study authors from Purdue University address this issue by evaluating emotional well-being, which pertains to an individual's daily emotions such as happiness, excitement, sadness, or anger. Additionally, they assessed life sa
Read more

7 Things People Waste Their Money On

Image
  Are you looking for ways to save money and avoid debt? If so, you are not alone. Many people struggle with managing their finances, especially during the holiday season. However, some simple and effective strategies can help you spend less and save more. In this blog post, I will share with you 7 things that people waste their money on, and how you can avoid them. Debt Dangers: Evade high-cost borrowing, as it can swiftly diminish your finances. High-cost borrowing refers to using credit cards, payday loans, or other forms of debt that charge high-interest rates and fees. These types of debt can quickly accumulate and become difficult to repay, especially if you miss payments or only pay the minimum amount. High-cost borrowing can also damage your credit score, which can affect your ability to get better loans or financial products in the future. To avoid high-cost borrowing, you should only use credit cards for emergencies or planned purchases that you can pay off in full every mont
Read more

A respond to pay for outcome based healthcare services

Image
  Health Minister Dzulkefly Ahmad wants private hospitals to shift from pay-for-service to pay-for-outcome to improve health outcomes and curb Malaysia’s high medical inflation rate from uncontrolled procedure costs Health Minister Dzulkefly Ahmad has called on private hospitals in Malaysia to adopt value-based health care to curb medical cost inflation and improve health outcomes.  Admitting that the country’s medical inflation rate of 12.6 per cent is high compared to the global average of 5.6 per cent, Dzulkefly urged private health care providers to shift from a pay-for-service model to a pay-for-outcome approach. “I urge private health facilities, especially the Association of Private Hospitals Malaysia (APHM), to consider this approach. As a minister, I want value-based health care — not pay-for-service but pay-for-outcome — to ensure payment effectiveness and health outcomes without fueling inflation due to uncontrolled procedure costs,” Dzulkefly said. The intention is good. Th
Read more