We are pleased to announce a 2–day Policy Course on A Policy Course on Health System Transformation in Financing: Development of a National Health Financing in supporting Universal health coverage in LMIC, which is offered by the Asia-Pacific Network for Health Systems Strengthening (ANHSS), and this time is co organised by the International Training Centre for Casemix and Clinical Coding (ITCC), HCTM, UKM.

The future challenges of an ageing population, the forthcoming new pandemics and NCDs and advancing technologies all play a role of increasing health care cost. Malaysia, Thailand and Indonesia are parts of the LMIC in Asia and have faced many challenges in sustaining financial budget, while serving its population. All countries uphold the universal health coverage (UHC) that ensures no one is left behind, despite their ability to pay for health. It is important to emphasize that the role of Private Health Insurance can not be neglected. The result of ANHSS meeting in Hong Kong in early May showed that there is a strategic role of Private Health Insurance in achieving universal health insurance.

Ensuring this trajectory, Indonesia has developed a social insurance system, through the INA-CBG (Indonesian Case Base Groups), that models its benefit packages for the population through the casemix system, and eligibility via some sort of medical card. This ensuring enough coverage despite the insured attending either the public or private sectors hospitals and payment to primary care through the capitation system.

Adopting the casemix system and DRGs especially for inpatients care, will lead to a more efficient payment system to healthcare providers. However, the need for audit and frauds detection are important to prevent financial leakages. Development of inclusive benefit packages for the population, are important to prevent omissions of groups of patients such as rare diseases, mental health groups and patients suffering from long in patients’ stay.  Essential Benefit packages in National Health Insurance (NHI), would include doctors’ services, inpatient and outpatient hospital care, prescription drug coverage, pregnancy and childbirth, mental health services, and more. The previous workshop which focused on Private health insurance (PHI) and examples from Hong Kong and other LMICs, highlighted the strengths and concerns of PHI, implementation wise.

In Malaysia, a proposed transition from a tax based health system, into a proposed National Health Insurance (NHI) using one pool, using the Malaysian DRG and some level of Social Health Insurance (SHI), are aimed to provide a sustainable value-based financing and future reimbursement system for the mass population. While the higher income may opt out, for voluntary health insurance or traditional fee for service (FFS). The involvement of policy makers, clinicians and specialist by their different fraternities are important stakeholders in this workshop.  Unlike private health insurance, whereby the insurance plans may vary in terms of services covered, with the presence of high deductibles and co-payments are required while individual premiums are charged based on health risks. The NHI in Malaysia may utilises premiums adjusted by population risks, rather than individual risk ratings. This workshop will cover aspects in SHI, its benefits and failures based on Asia Pacific country’s experiences.

Case studies on countries experienced in implementing SHI and benefit packages, for integration will be presented for learning purposes. A final session will cover critical factors for policy development, implementation, approaches in monitoring and evaluation of policy interventions.

The course will provide participants with:

1. Understand the policy options of a public and private financing mix in National Health Insurance system in supporting UHC.
2. Understanding the strengths, challenges and issues confronting both tax-based healthcare (issues on sustainability) and social insurance health systems in the transformation of a health system.
3. Understanding the difference between user fee for services, health insurance (private vs social), and the use of benefit packages.
4. Inform stakeholders on the method of value-based reimbursement and use of auditing in NHI.
5. Formulate implementation, monitoring and evaluation strategies for strengthening public, SHI and private health insurance in

Registration and proof of payment is to be made to Madam Siti Hajarni at :
casemix@hctm.ukm.edu.my
Office Nu : +603 9145 8401
Fax Nu: +603 9145 6670

Payment Information
Account Holder Name : Asia Pacific Network For Health Systems Strengthening Limited
Address : 2/F, School of Public Health Building, 30-32 Ngan Shing Street
Prince of Wales Hospital, Shatin, New Territories, Hong Kong
Account Number : 44719019993 (USD SAVINGS A/C)
Bank Name : Standard Chartered Bank (Hong Kong) Limited
Bank Address : Payment Centre, 15/F Standard Chartered Tower
388 Kwun Tong Road, Hong Kong
Swift Code : SCBLHKHHXXX

Registration Amount : USD 200 (international participants) and USD 150 (for Malaysians)

Hybrid session will be done.

Speaker from: Malaysia, Hongkong, China, Thailand, Indonesia, Sri Lanka and other