Adjusting Criteria for Outpatient Services in Bangkok: NHSO Board Decision

2024-03-26 14:14:00

NHSO Board considers adjusting the criteria for paying for outpatient services in the Bangkok area. As for medical fees for service units, from 200 to 100 baht, but increasing the proportion of expenses for health promotion and disease prevention.

On March 20, 2024, the meeting of the National Health Security Committee (NHSO Board) No. 3/2024, with Dr. Chonnan Srikaew, Minister of Public Health (Ministry of Public Health), as chairman. The NHSO board acts as meeting chair. with important agenda item 4.9 Adjusting the medical fee payment rate for outpatient services in the Bangkok area which was presented by Dr. Lalitaya Kongkham, Deputy Secretary General of NHSO.
Dr. Lalitaya told the meeting that From the resolution of the meeting of the District Health Security Sub-Committee, District 13, Bangkok (OCS District 13, Bangkok) No. 1/2024 regarding the criteria for paying for outpatient services in the Bangkok area. There are proposals and recommendations for setting payment criteria for outpatient services in the Bangkok area for the NHSO to consider. It is recommended to adjust the model for allocating funds for outpatient services according to Capitation to primary care units. From March 1, 2024, by setting aside a portion of the money to pay in the Free Schedules program when it is forwarded from the remaining budget to pay in lump sum payments per head. In the case where people go to receive services without referral, they pay in the form of Free Schedules from the central budget.
There is also a proposal to cancel the payment of the 100 baht per day primary care service fee and in the case of referrals. Request adjustment of payment for outpatient services and medical fees From the actual payment not exceeding 200 baht per time to the actual payment not exceeding 100 baht per time, both in government and private hospitals, with immediate effect.
In this regard, NHSO led discussions at the legal sub-committee meeting No. 3/2024 on March 12, 2024 to provide opinions on adjusting expenditures for public health services. General outpatient cases in Bangkok Which will come into effect retroactively or not? As for the resolution of the Legal Subcommittee Have an opinion NHSO can consider recommendations or opinions from the NHSO. However, in cases where the NHSO does not agree, it can propose it to the NHSO for reconsideration.
However, NHSO has established criteria for paying expenses. By adjusting the proportion of lump sum payments per head per person. or pay according to service performance Or in both cases, by paying in 3 parts, consisting of 1. Add a list of services and target groups. by covering the cost of basic health screening in the community and proactive service fees in the community 2. Health promotion and disease prevention service fees for each age group After screening and finding 11 risk groups, and 3. adding payment criteria for health promotion and disease prevention according to the goals and service results of the primary care unit. At a rate not exceeding 30 baht per population in Bangkok area In cases other than the 11 health screening items and items in the Free Schedules set by NHSO
The meeting considered and agreed to adjust the criteria for paying expenses for outpatient services by having NHSO adjust the format for allocating money for outpatient services according to Capitation to primary care units. From March 1, 2024, along with agreeing to adjust the medical fee payment rate for outpatient services in the Bangkok area. According to advice or opinions from the Public Health Office.
Including also agreeing to adjust the criteria for paying expenses for health promotion and disease prevention by allowing NHSO to proceed according to the specified criteria. and to proceed immediately
Dr. Jadej Thamthatcharee, Secretary-General of NHSO, said at the meeting that from now on, NHSO will go to understand and rehearse about services with primary care units. Especially with the participating warm community clinics regarding the criteria for payment of services. Including health promotion and disease prevention services for the people. that will be a service disbursed to NHSO can get more if they provide comprehensive services. However, if there are impacts or problems that follow. There will be assessment and monitoring. Along with reporting to the OCS for further discussion.