NHSO keeps improving healthcare financial payment system as fighting COVID-19
 
The COVID-19 outbreak continues to strain healthcare providers physically and financially. As they have to cope with the increased workload associated with screening patients for the new coronavirus infection and treating them if they are infected, the extra work always come with extra costs.
 
Even though, these costs will definitely repay for later, the usual speed of financial reimbursement may no longer be fast enough for many healthcare facilities to catch up with a rapid rise in their operation costs.
 
National Health Security Office (NHSO) is well aware of this problem and trying to adjust its health financial reimbursement system in order to better cope with the changing situation of COVID-19 and its financial impact on these healthcare providers.
 


The NHSO’s ultimate goal is to make it possible to pay all financial reimbursement to service providers instantly after claims are submitted, said Dr Jadej Thammatach-aree, secretary-general of the NHSO.
 
In order to achieve that goal, the NHSO continues improving its information technology system, a task that still need more time to achieve as it basically deals with such a substantial database system, he said.
 
From previously that the NHSO normally allowed healthcare providers to once a month submit claims for the costs of services reimbursement, they have provided to patients under the Universal Coverage Scheme (UCS), it has now changed to every 15 days, said Dr Jadej.
 
“We do hope this change will help improve hospitals’ liquidity and their ability to cope better with the changing outbreak situation that requires both work efficiency and flexibility” he said.
 
Also, artificial intelligence (AI) technology has been adopted to help control quality and efficiency of the NHSO’s health financial compensations, he said.
 
Since the beginning of this year until the end of March, a total of 781,625 COVID-19 screening tests had been carried out, which cost the NHSO 1.86 billion baht. A total of 31,488 times of COVID-19 treatment, which cost 1.49 billion baht in total, were provided during the same period.
 
COVID-19 screening is seen as a crucial mechanism in the containment of the outbreak, National Health Security Fund has previously begun offering COVID-19 screening and laboratory testing to people who meet the Patient under Investigation (PUI) criteria set by the Department of Disease Control for deciding as to who should be given a free COVID-19 test.
 
Most recently, The NHSO has announced that physician will deciding on a case-by case basis as to who else should be screened for COVID-19 and the cost of testing will be covered by NHSO .
 
Along with this change in COVID-19 screening policy, the NHSO has also encouraged private hospitals that aren’t contracted service providers under the UCS to become a part of the same COVID-19 screening network.
 
Four types of COVID-19 tests are covered by the NHSO, namely reverse transcription polymerase chain reaction (RT-PCR) testing of nasal and throat swabs, RT-PCR testing of pooled saliva samples combined with pooled nasal and throat swab samples, antibody testing and antigen testing.
 
The NHSO has already reached an agreement with private hospitals that they must not charge a new confirmed COVID-19 patient who tested at a private hospital and needs to be admitted for treatment, said Dr Jadej.
 
Financial reimbursement for such a healthcare service will later repay under the Universal Coverage for Emergency Patients (UCEP), unless the service is already covered by patients’ own health insurance policies.
 
“Because COVID-19 is considered a health emergency that comes as a heavy financial burden to many people, we would like to assure all of you that if you strictly follow advice by doctors at the healthcare facility you are receiving [COVID-19 treatment] services, you won’t have to pay any extra costs,” he said.
 
And in a bid to help everyone find a proper COVID-19 screening test at a proper healthcare facility closet to his or her home, the NHSO now offers on its website a service allowing just everyone to look up as to what healthcare rights they are entitled to and which healthcare facilities they should consider visiting when it comes to testing for COVID-19.
 
Later on April 5, the National Health Security Board approved a proposal pertaining to regulations governing the spending of 3.75 billion baht received from the government’s loan decree for COVID-19 relief and economic and social rehabilitation.
 
The fund was allocated to the NHSO under a cabinet resolution reached on March 30, 2021.
Of the 3.75 billion, 3.65 billion will go to healthcare services associated with COVID-19 and the rest of about 1 billion baht will be spent on other related costs.
 
The cabinet has requested that the NHSO spend this sum of money separately from the UCS capitation payment.
 
 And these are how the NHSO have been working to boost public confidence in access to healthcare services necessary for saving lives and containing the spread of COVID-19 since its emergence in Thailand in early 2020.