Private hospitals opting out of govt health scheme

Reduced services ‘ insurance, which resulted in significant loss

Due to the mounting losses caused by the lower reimbursement for some patient solutions, more private hospitals may decide to reapply for their involvement with the federal social security system.

The Private Hospitals Association ( PHA ), the president of Paiboon Eksaengsri, reported on Tuesday that the number of private hospitals participating in the Social Security Office’s ( SSO ) healthcare program had dropped from 123 to 93 in the last ten years.

Due to the low reimbursement they received for the care of patients with major problems, the 30 hospitals parted ways with the SSO. This cost&nbsp, them a lot of money they were never reimbursed for.

Treatment is covered by the SSO health insurance plan at both partnered private institutions and public hospitals. The Social Security Fund is used to make repayments. The SSO finances 1, 808 ringgit for each person for standard medical insurance since last year, up from the previous 1, 640 ringgit, Dr Paiboon said.

However, it has reduced payments to associated hospitals for patients who have serious or persistent health issues using an” changed relative weight” formula. Payment to associated clinics under this plan was set at 12, 000 baht&nbsp,” adjusted equivalent bodyweight” in 2020. It was reduced to 10, 000 ringgit in 2022.

According to the PHA, the transaction had been reduced this year in the past two decades to 7,200 baht. The relationship claimed that this was due to a funding crisis. &nbsp,

According to the Public Health Ministry, adjusted equivalent mass is a method used to determine acute settlement in diagnosis-related groups.

Dr. Paiboon claimed that the associated private hospitals were paying a lot for the finances reduction. Costs were mounting. &nbsp,

The condition, unless rectified, would push more private clinics to remove from the program, he said. This may place an extra burden on people hospitals, where individual numbers would increase. &nbsp,

New private clinics could meet the programme, but most were little and could not provide a large number of SSO users, he added.

The SSO is under the Labour Ministry. This time, it has about 25 million people.

Somsak Thepsutin, the minister of public health, said on Tuesday that a solution to the PHA’s issue may be found if hospitals received more budget money through the SSO. But he did not provide any information.

The PHA’s issue has been addressed by both the SSO nor Labour Minister Phiphat Ratchakitprakarn.