The Private Hospital Association (PHA) has welcomed the government’s commitment to push for a fixed minimum monthly reimbursement rate of 12,000 baht per patient for inpatient care under the social security system.
The positive response to last week’s promise by Labour Minister Phiphat Ratchakitprakarn was seen as a sign that some privately run hospitals may be willing to reconsider their threat to stop treating Social Security patients because of insufficient funding.
The promised 12,000-baht rate is lower than the 15,000 baht previously demanded by the PHA to reflect the expense members bore for some higher-cost inpatient treatments.
However, the association will want assurances from the government that the rate will not be reduced in the future. Such a guarantee could influence more than 70 privately run hospitals currently considering leaving the social security system, said Dr Paiboon Eksaengsri, the PHA president.
The government last year promised a 12,000-baht reimbursement rate at the start of the year but later cut it to 7,200 baht when the fund earmarked for covering high-cost inpatient treatments began running low, Dr Paiboon said.
The rate is calculated using the adjusted relative weight method, which takes into account a hospital’s burden in providing care for inpatients undergoing high-cost treatments under Social Security.
Of the 93 private hospitals nationwide currently serving the social security system, more than 70 have petitioned the government to resolve the reimbursement rate issue with the Social Security Office (SSO).
These 93 hospitals represent a small portion of the more than 400 private hospitals operating across the country, Dr Paiboon noted, adding the petition should not be viewed as a threat.
The hospitals initially joined the system because they believed that becoming contractual partners with the system would provide financial stability.
“In truth, we don’t want to leave the social security system, as we’ve been working together for a long time. However, if the costs of running medical services under Social Security cannot be managed, we would have to reconsider our participation,” he said.
Dr Chalerm Harnphanich, a former president of the PHA, meanwhile, urged the SSO to conduct regular reviews of healthcare capitation and reimbursements for hospitals to keep up with inflation.
