Kuala lumpur: ProtectHealth Corporation Sdn Bhd (ProtectHealth) is on track to roll out the Diagnosis-Related Group (DRG)-based pricing guidelines under the base Malaysia Health Insurance and Takaful Initiative (MHIT) plan by January next year, with more than 100 private hospitals having submitted data for the system since this February.
According to BERNAMA News Agency, data submitted by participating hospitals are currently being analyzed together with technical experts from the Ministry of Health (MOH), Bank Negara Malaysia (BNM), and other agencies to develop the initial DRG pricing framework ahead of a pilot rollout in the third quarter of this year. ProtectHealth's CEO, Wan Mohd Hazwan Wan Mohd Najib, stated that an initial version is expected to be ready before the pilot, with ongoing refinements leading up to the national launch.
The DRG-pricing guidelines are designed to enhance transparency in hospital charges while mitigating 'pricing shock' for hospitals and patients through a phased implementation approach. Wan Mohd Hazwan emphasized that the government's healthcare reform agenda, including the DRG-based pricing mechanism rollout and the expansion of public-private healthcare collaboration, remains unaffected by global economic uncertainties and healthcare inflation pressures.
Malaysia's dual healthcare system remains robust, with efforts to optimize both public and private healthcare resources being crucial to maintaining timely and affordable treatment for Malaysians, especially as global medical costs and insurance premiums rise. Wan Mohd Hazwan highlighted the importance of ensuring accessible and affordable healthcare through stronger collaboration between the public and private sectors.
Meanwhile, ProtectHealth's strategic programme development head, Dr. Gan Saw Chien, pointed out Malaysia's strong foundational capability in DRG implementation, noting the MOH's decade-long use of medical coding systems linked to DRG. He clarified that the DRG framework under the base MHIT plan would apply to inpatient hospital cases, differing from the Hospital Services Outsourcing Programme, which employs a separate case-based payment model for elective procedures.
In January, Finance Minister II Datuk Seri Amir Hamzah Azizan announced that Bank Negara Malaysia would strengthen regulatory requirements for all MHIT products following the introduction of a standardized base MHIT plan aimed at enhancing consumer protection and ensuring long-term premium sustainability. MHIT, to be offered voluntarily, is slated for a pilot rollout in the second half of this year, with full implementation targeted for early 2027.