‘Outcome-based’ fees system needs careful planning, say private hospitals

 

The Association of Private Hospitals Malaysia wants the health ministry to first study the application of value-based healthcare principles in the public healthcare delivery system.

PETALING JAYA: 

The Association of Private Hospitals Malaysia (APHM) has welcomed the health minister’s proposal for 

outcome-based

 healthcare fees in private hospitals, but calls for careful planning to ensure it benefits all stakeholders.

APHM president Dr Kuljit Singh said there were some potential drawbacks, depending on the mechanism, in the proposal for value-based healthcare fees, charged based on the outcomes of treatment.

Kuljit said private healthcare facilities could struggle in transitioning from a fee-for-service model to one that was value-based, and that setting criteria on the quality or outcomes of treatment could be 

problematic

.

“High-risk patients may be overlooked by doctors due to performance expectations, potentially leading to under-treatment or rejection.

“New payment mechanisms that shift financial risk can also dissuade providers and payers. Patients may be opposed to changes in therapy availability and delivery.

“Value-based healthcare payment systems offer potential but they necessitate careful planning, stakeholder engagement, and the resolution of technological, organisational and cultural challenges.

We expect the health ministry to conduct a comprehensive study to review the public healthcare delivery system, utilising value-based healthcare principles that are tax-funded. This will encourage private organisations to replicate them,

 he said in a statement.

In the Dewan Rakyat earlier today, health minister Dzulkefly Ahmad urged private hospitals to introduce 

pay-for-outcome

 fees to curb medical inflation and improve the outcome of healthcare treatments.

He said Malaysia’s inflation in medical costs had reached 12.6%, more than double the global average of 5.6%.

Kuljit said another issue that might surface was incompatible electronic health records, which would hinder data sharing and interoperability.

Nonetheless, he acknowledged that other countries had employed the same model with some success.

“In the UK’s National Health Service, pay-for-performance initiatives have increased quality to some extent, while bundled payments encourage clinicians to plan ahead of time to avoid complications.

Capitation regimes in Japan and the Netherlands have prioritised population health and prevention by pushing providers to engage in preventive care and integrated care systems to enhance chronic illness treatment. - FMT