A Policy Course on:
    Private Sector Engagement for Health System Goals and to Advance Universal Health Coverage

    Private Sector Engagement for Health System Goals and to Advance Universal Health Coverage

     

    Welcome Remarks

    Prof. Dr. Laksono Trisnantoro – Professor of Health Policy and Management, FK-KMK UGM

    The first day of the policy course (May 6, 2025) began with opening remarks from Prof. Laksono, Chair of ANHSS, who inaugurated the course by introducing ANHSS members from across the Asia-Pacific region, including Thailand (initiated by Prof. Supakankunti and Prof. Chantal Herberholz), Malaysia, the Philippines, Indonesia (Prof. Laksono), and Hong Kong as the host.

    In his remarks, Prof. Laksono emphasized the importance of cross-sector collaboration across the Asia-Pacific in strengthening health systems. Since its inception in 2011, he has stressed the need for policy dialogue, especially on strategic issues such as private health insurance (PHI). He expressed hope that this policy course would enable participants to explore new approaches and build networks for collaboration in research and capacity-building, particularly in optimizing the role of PHI.

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    Structure of the Course

    Prof. Eng-kiong Yeoh – Director, Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong (HKSAR, China)

     

    Prof. Yeoh explained the structure of the policy course, which focuses on a conceptual framework for private sector engagement in achieving health system goals. He outlined how private sector involvement can support objectives such as improving equity, financial risk protection, efficiency and effectiveness, as well as continuity and integration of health services. The private sector can contribute in many ways, including as payers, healthcare service providers, and suppliers (e.g., of medicines or medical equipment).

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    The Role of the Private Sector in Health Financing

    Speaker: Prof. Siripen Supakankunti – Professor, Centre of Excellence in Health Economics, Faculty of Economics, Chulalongkorn University, Bangkok, Thailand

    Prof. Siripen discussed the role of the private sector in health financing across the Asia-Pacific region. She explained that public and private health systems must be interconnected. In countries that rely heavily on tax-based or social health insurance financing, private sources such as private health insurance, loans, investments, equity, and philanthropic contributions can help fill gaps in health financing.

    However, she noted that progress in integrating private financing sources varies by country. For instance, India and Lao PDR still lack regulatory frameworks to formally incorporate private health insurance into their national health systems. Across the Asia-Pacific—especially in developing countries—efforts to optimize the role of private health insurance remain diverse.

    In conclusion, Prof. Siripen stated that PHI can serve as a supplement or a “safety valve” for the public health system. PHI offers individuals access to a broader range of services and can stimulate infrastructure development (e.g., hospitals, clinics, medical technology). However, such development must be carefully managed to avoid worsening equity gaps.

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    Integration of Financing and Provision of Primary Healthcare in the Private Sector

    Speaker: Dr. Yat Chow – Executive Medical Director, BUPA Insurance & Quality Healthcare Services (HKSAR, China)

    Dr. Chow discussed the integration of financing and primary healthcare services in the private sector based on BUPA’s experience. BUPA comprises three entities: BUPA (private health insurance), Quality (healthcare service provider), and BLUA (a digital health integration platform). BUPA offers three service models:

    1. Conventional insurance providing full coverage
    2. Subscription-based or capitated outpatient care with partial coverage
    3. Public-private partnership with the government via outsourcing, where the Hong Kong government funds BUPA’s services through Quality Healthcare.

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    Private Health Sector Assessment (PHSA)

    Speaker: Shita Dewi – Center for Health Policy and Management, FK-KMK UGM (Indonesia)

    In the afternoon session, Shita Dewi from PKMK presented the topic “Private Health Sector Assessment” (PHSA). PHSA serves several purposes, such as identifying the role of the private sector within a country, diagnosing the relationship between public and private sectors, analyzing the private sector market, and formulating strategic steps for engagement.

    Key considerations in PHSA include identifying the types of information required about the private health sector. The assessment methods are highly varied depending on the intended objectives. After defining the goals of PHSA, the next step is to develop an assessment strategy. Guiding questions include:

    • What quantitative data is needed to understand the private sector’s role?
    • What qualitative data is required to uncover motivations, opportunities, and challenges?
    • What are the most appropriate data collection methods?
    • What outcomes should the PHSA achieve?

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    After the presentation, participants were grouped by country to conduct a case reading exercise. The purpose was to design a PHSA strategy based on previously distributed journal articles.

    Following the knowledge event and policy course held on 6–7 May 2025, the ANHSS committee, in collaboration with the authorities of the City University of Hong Kong (CUHK) Medical Centre, organized a hospital tour on 8 May 2025. The hospital tour was guided by Prof. Hong Fung, Chief Executive Officer of CUHK Medical Centre (CUHKMC).

    Public Lecture on Hong Kong’s Health System & Private Health Insurance: Case Study of CUHK Medical Centre

    The event commenced with a lecture delivered by Prof. Hong Fung. In his presentation, he elaborated on the role of private healthcare services in Hong Kong, specifically the contribution of private hospitals and healthcare facilities within the overall health system landscape of the region.

    Prof. Fung emphasized that in Hong Kong’s healthcare system, no citizen should be left without access to health services, which underpins the framework of their health system. Private healthcare services (PHS) are positioned as complementary to public services, the latter being governed under the framework of the Hospital Authority (HA).

    Despite demographic and epidemiological challenges, such as a predominantly ageing population, Hong Kong maintains its commitment to health equity. Within this framework, CUHKMC offers specialized services that ensure comfort and continuity of care. For instance, CUHKMC has implemented key initiatives like a chronic disease co-care scheme to embody the public-private mix approach. Additionally, it offers a comprehensive cancer service supported by mixed financing mechanisms. CUHKMC’s role spans across the continuum of care—from preventive to palliative and survivorship care for post-remission patients.

    One of CUHKMC’s notable strengths, and a broader characteristic of healthcare facilities in Hong Kong, is price transparency. All medical package prices are made openly available to consumers. Prof. Fung stated that any pricing changes are announced at least three months in advance, fostering patient trust in the system.

    In setting the price of general health service packages, CUHKMC applies a model similar to the Diagnosis-Related Group (DRG) known locally as the Diagnosis-Intervention Package (DIP). By adopting an evidence-based and regularly updated pricing structure, price variations among patients are minimized, promoting efficiency and equity.

    Facilities & Key Programs

    The hospital tour began with a visit to the general inpatient ward. Each room was equipped with a secure medication cabinet featuring fingerprint access for authorized staff, which significantly reduces the risk of drug misplacement or theft.

    Next, in the OBGYN ward, various types of inpatient accommodations were presented:

    • Private: one bed per room
    • Semi-private: two beds per room
    • Shared: four to eight beds per room

    Private and semi-private rooms are covered by private insurance or out-of-pocket payments, while shared rooms are typically covered under public insurance.

    Each OBGYN inpatient is also provided with a monitor connected to CCTV, allowing real-time location tracking of the patient, similar to Apple’s “Find My” feature. Additionally, mothers and newborns are equipped with monitoring devices for easy identification and enhanced safety.

    A notable innovation at CUHKMC is the automated prescription system. In the pharmacy storage area, automation technology sorts medications by dosage and packages them by daily consumption for each patient. These packages are delivered with identification wristbands. This system significantly minimizes the risk of missed doses.

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    Background

    The ageing of the global population is associated with a rising prevalence of chronic disease and preventable illness, generating escalating demands for health care and creating pressures on the sustainability of health systems. Health expenditures are projected to grow at rates that outpace government revenue growths, raising concerns on the long-term financial sustainability. To address this issue and encourage countries to build resilient health systems, The United Nations identified Universal Health Coverage as one of its Sustainable Development Goals. Reform in health systems is comprehensive, focusing on health financing, procurement and provision of services. Financing of different types and levels of healthcare for integrated delivery is critical to meet the complex needs of people with chronic disease and for efficiency and equitable healthcare.

    In the Asia Pacific Region, fragmentation of heath care service delivery is evident. Coordination of services within primary care, between primary community care and specialist hospital care is limited and problematic. Public and private healthcare systems effectively operate in segmented parallel systems which compromise effectiveness and efficiency of health systems. Countries have implemented policies such as the expansion of private health insurance schemes to engage the private health sector transformed primary care led system. However significant challenges have impeded progress, including rapidly rising healthcare costs, incongruity between insurance benefits and people’s needs, as well as political and legislative indifferences.

    The course will provide an overview of private sector engagement from the perspectives of stakeholders including policymakers, regulators, economists and insurers. The engagement of players in the private sector involved in the procurement, provision and assessment of services will be explored where the patient’s experiences of access to care and financial protection in the private sector will be discussed. One such actor that enables access to care in the private sector is Private Health Insurance (PHI), purchased by individuals to supplement, complement, or substitute public health financing methods. PHI plays a critical role in protecting individuals from financial risks, particularly against catastrophic medical expenses. The business and regulatory environments will also be explored to understand the needs of commercial operators and regulators so private actors can effectively contribute to overall health financing whilst maintaining profitability in their core business activities. Case studies on country experiences of private sector engagement based on the different health system designs will be presented for learning.

    Objectives:

    The course will provide participants with:

    1. Analysis of health system needs and challenges from the perspectives of multiple stakeholders, including policymakers, regulators, economists, and insurers.
    2. Analysis of the engagement of players in the private sector, the industry practices that drive the purchasing and procurement of services, and the associated impacts on the design of insurance products offered on the market.
    3. Inform decisions in the choice of commercial financing products like PHI in funding the provision of healthcare services in the private sector.
    4. Understanding patient experiences in the private sector, in terms of access to care, quality of care and financial protection.

    Target Audience:

    The primary target audience for the course are senior and mid-level policy makers at national and sub-national level, health policy implementer, health sector managers and practitioners working with the private sector and regulators. Heads/directors of private health care organization/ associations, academia and researchers in health services, system and policy, and global and international organizations/development partner representatives might also find this course useful.

    Invited Speakers:

    The Policy Course brings together a diverse group of esteemed speakers from across the Asia Pacific Region to share their expertise and insights.

    Opening Session:

    • Professor Laksono TRISNANTORO (Professor, Gadjah Mada University, Indonesia)
    • Professor E.K. YEOH (Director, Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong)

    Faculty Members:

    • Dr. Eduardo P. BANZON (Director, Health Sector Group, Asian Development Bank, Philippines)
    • Professor Ying-Yao CHEN (Professor, Fudan University, China)
      Dr. Yat CHOW (Executive Medical Director, Bupa Hong Kong, Hong Kong SAR, China)
    • Shita DEWI (Health Policy and Public Health Division, CHPM, Universitas Gadjah Mada, Indonesia)
    • Professor Chantal HERBERHOLZ (Professor, Chulalongkorn University, Thailand)
    • Professor Soonman KWON (Professor, Seoul National University, South Korea)
    • Professor Siripen SUPAKANKUNTI (Professor, Chulalongkorn University, Thailand)
    • Professor Sharifa Ezat WAN PUTEH (Professor, Universiti Kebangsaan Malaysia, Malaysia)

    Please refer to the programme rundown for the detailed course content. 

    Venue:

    • Day 1: KCTCRC, 1/F School of Public Health Building, Prince of Wales Hospital, Shatin, Hong Kong. 
    • Day 2: Alva Hotel by Royal, 1 Yuen Hong Street, Shatin, Hong Kong. 
    • Day 3: CUHK Medical Centre, 9 Chak Cheung Street, Shatin, Hong Kong. 

    Please refer to the programme rundown for the detailed schedule.

    Registration Fee:

    The standard tuition fee for the course (May 6-8th, 2025) is USD 200. This fee includes tuition, course material, one field visit, coffee breaks and lunch during the days of the training. 

    Participants (or their funding agency) will be responsible for covering the costs of travel, health and accident insurance, accommodation, and other expenses while in Hong Kong. 

    An early bird fee of USD 150 per person will apply for participants whose payments are received before 7 April 2025. [Extended to 14 April 2025]

    Registration Link

    Please fill the registration link below:
    https://cuhk.qualtrics.com/jfe/form/SV_bpW0lqkwuwfp2bs

     

    Payment details:

    Once registered, we will provide an invoice number to you by email.

    For local/ overseas participants: For bank direct transfer/deposit, please quote the invoice number and make payment to the following bank account:

    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

    :

    44719019985 (HKD SAVINGS A/C) OR 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

    For local participants ONLY: For cheque payment, please make cheque payable to  Asia Pacific Network For Health Systems Strengthening Limited and mark the invoice number on the back of the cheque and send the cheque to Room 201, 2/F, School of Public Health, Prince of Wales Hospital, Shatin, Hong Kong.

     

    Hotel Information: 

    Please refer to  https://hspr.cuhk.edu.hk/hotel-accommodations for hotels near the course venue.

     

    Date: May 6, 2025

    Venue: KCTCRC, 1/F School of Public Health Building, Prince of Wales Hospital, Shatin, Hong Kong

    AGENDA OVERVIEW

    8:45 AM – 9:00 AM | Registration
    Welcome Remarks:
    Laksono TRISNANTORO, Professor of Health Policy and Management, Department of Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada (Indonesia)
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    Structure of Course:
    Professor Eng-Kiong YEOH, Director, Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong (HKSAR, China)
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    9:15 AM – 10:45 AM | Teaching Presentation 1

    Topic: The Role of the Private Sector in Health Financing
    Speaker: Professor Siripen SUPAKANKUNTI, Professor, Chulalongkorn University  (Thailand)
    Abstract:
    The session investigates explicitly the expanding role of private health insurance and the persistence of out-of-pocket payments as critical yet complex sources of healthcare funding. It analyzes how these private financing avenues reshape healthcare landscapes by influencing consumer choices, driving the growth of private hospitals and clinics, and impacting the pharmaceutical and medical device industries.
    While acknowledging the private sector’s contributions to expanding healthcare access and fostering innovation, the session underscores the critical need for effective governance and targeted policy interventions. Addressing challenges related to equitable access, cost containment, quality assurance, and seamless coordination between public and private healthcare providers is essential to ensure a sustainable and inclusive healthcare system that benefits all members of society. The session highlights the vital role of strategic public-private partnerships, a renewed focus on primary care and prevention, and data-driven policymaking in shaping a more equitable and efficient health financing future for the region.

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    10:45 AM – 11:15 AM | Tea & Refreshments

    11:15 AM – 12:45 PM | Teaching Presentation 2

    Topic: Integration of Financing and Provision of Primary Healthcare in the Private Sector

    Speaker: Dr. Yat CHOW, Executive Medical Director, Bupa Insurance & Quality Healthcare Medical Services (HKSAR, China)

    Abstract:
    The provision of healthcare services in the private sector is a critical component of modern health systems, particularly in the context of integrated care between health insurers and health service providers. This presentation explores the dynamics of such integration, focusing on outpatient services within the private health sector. The primary care model serves as the foundation for this integration, emphasizing the importance of coordinated and continuous care for patients.
    Integration is achieved through various mechanisms, including shared information systems, collaborative care planning, and financial incentives aligned with quality outcomes. Health insurers and providers work together to streamline processes, reduce redundancies, and enhance patient experiences. Participation in public-private partnership (PPP) programs further strengthens this integration by leveraging the strengths of both sectors to improve service delivery and accessibility.
    This integrated approach contributes significantly to the overall healthcare system by improving efficiency, reducing costs, and enhancing the quality of care. It fosters a more patient-centered approach, ensuring that individuals receive timely and appropriate care. Additionally, it supports the sustainability of the healthcare system by optimizing resource utilization and promoting preventive care.
    However, several barriers to effective integration exist, including regulatory challenges, differences in organizational cultures, and resistance to change among stakeholders. Overcoming these barriers requires robust policy frameworks, continuous stakeholder engagement, and the adoption of best practices from successful integration models. The presentation will delve into case studies and real- world examples to illustrate how these challenges have been addressed in various contexts.
    In conclusion, the integration of healthcare services in the private sector, facilitated by collaboration between health insurers and providers, plays a pivotal role in enhancing the overall healthcare system. By examining the mechanisms of integration, participation in PPP programs, and the impact on primary care, this presentation provides a comprehensive understanding of the benefits and challenges associated with this approach.

    12:45 PM – 2:30 PM    Lunch break

    2:30 PM – 3:30 PM | Teaching Presentation 3 (Part 1)

    Topic: Private Health Sector Assessment
    Speaker: Shita DEWI, Health Policy and Public Health Division, CHPM, Universitas Gadjah Mada (Indonesia) 

    Abstract:
    Private Health Sector Assessment (PHSA) is the first step in engaging the private sector. PHSA is an assessment aiming at the private health sector to get some basic information needed in order to select appropriate strategies to engage private providers more strategically/effectively. Ultimately, PHSA should help develop policy recommendations for enhancing the private sector’s contribution to alleviating identified problems, enhance health policy decision-making, promote public – private dialogue and create forward momentum. The objective of this session is to provide insight into how to conduct a private health sector assessment (PHSA) tailored to participant’s country. The session will highlight the importance of PHSA in engaging private sector, tools for conducting PHSA and how to link the PHSA result to the PSE strategy options.
    A private health sector assessment is an important first step towards more strategic engagement of private sector actors in order to achieve sector goals. PHSAs are tools to inform policy and stakeholder dialogue. Research reports are not the primary objective of a PHSA. And it is crucial to understand that dialogue, policy prioritization, and forward momentum are the objectives of a PHSA, not a report.

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    QUESTIONS TO DISCUSS AND THINK ABOUT 

      • How will you use your PHSA to develop a strategy that suits the context of your county?
      • How will you engage your stakeholder to develop this strategy?

    RECOMMENDED READING

    Chakraborty, S. & Harding, A., 2003. Conducting a Private Health Sector Assessment. In: A. S. Preker & Harding, eds. Private Participation in Health Services. Washington: World Bank, pp. 75-156.

    Private Health Policy Toolkit. Tools for Engaging the Private Health Sector. Washington: World Bank, 2013.

    3:30 PM – 4:00 PM | Tea & Refreshments

    4:00 PM – 5:30 PM | Teaching Presentation 3 (Part 2)

    Topic: Private Health Sector Assessment
    Speaker: Shita DEWI, Health Policy and Public Health Division, CHPM, Universitas Gadjah Mada (Indonesia)

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    Regional Knowledge Event: The Strategic Role of Private Health Insurance (PHI) for Health System Goals and to Advance Universal Health Coverage

    Date: May 7, 2025

    Venue: Alva Hotel by Royal, 1 Yuen Hong Street, Shatin, Hong Kong

    AGENDA: Please refer to Knowledge Event programme rundown for detailed schedule.

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    Date: May 8, 2025

    Venue: CUHK Medical Centre, 9 Chak Cheung Street, Shatin, Hong Kong

    8:45 AM – 9:00 AM | Registration

    9:00 AM – 9:45 AM | Teaching Presentation 1

    Topic: The Private Hospital and Specialist Sector in Hong Kong

    Speaker: Professor Hong FUNG, Executive Director and CEO of CUHK Medical Centre; Professor of Practice of JC School of Public Health and Primary Care (HKSAR, China)

    Abstract:
    Private hospital and specialist care in Hong Kong used to play a supplementary role to the public hospital system under the Hospital Authority. The private sector offers choice of doctors, faster access with short waiting time, and better accommodation and hospitality services. There is, however, an imbalance between public and private healthcare with 90% of the secondary and tertiary care services being taken up by the public hospitals while nearly half of the specialist doctors work in the private sector. The imbalance has grown since the Covid-19 pandemic with worsening waiting time in the public sector for elective services and cost escalation in the private sector. The latter is mainly reflected in the worsening loss ratios among the private health insurers, leading to major increases in premiums and driving more patients to the public sector.

    The government of the Hong Kong Special Administrative Region has been introducing reform measures to the private sector. These measures include the introduction of the Voluntary Health Insurance Scheme (VHIS), which provides a regulatory framework for the health insurance products, regulation of private healthcare facilities as well as requiring private hospitals to publish their historical charges for 30 common surgical procedures. A key theme under VHIS and the requirement of publication of historical charges is to promote price transparency. But according to a report published by the Hong Kong Consumer Council in March 2025, price transparency remains a major issue in private healthcare.

    This lecture will examine the respective roles of the payers, the hospitals, and the medical specialists in private healthcare and in contributing towards Universal Health Coverage. It proposes package pricing as the foundation for promoting price transparency and affordability of private healthcare. Setting the foundation would enable the building of different financial pillars to make private healthcare more affordability and accessible. The lecture will be followed by a hospital visit to study the use of technology in the development of a smart hospital and supporting the Triple Aim in healthcare delivery.

    9:45 AM – 10:15 AM | Certificate Presentation Ceremony

    10:15 AM – 10:30 AM | Tea Break

    10:30 AM – 11:30 AM | Tour of CUHK Medical Centre

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