The "30-baht Treatment Anywhere," which requires only a Thai national ID card to access health services, is a quick-win policy introduced by the Thai government to improve accessibility and the quality of the Universal Coverage Scheme (UCS) through digital transformation.
 
Currently, the "Treatment Anywhere" initiative is in its pilot phase in 12 provinces, with the expectation of fully implementing it nationwide this year. Under the "Treatment Anyway" model, UC beneficiaries can access healthcare services at their designated first point of contact, primary care services, and private hospitals registering with the National Health Security Office (NHSO). Moreover, UC beneficiaries can get their healthcare services at pharmacies, private clinics, and private laboratories for minor illnesses and health promotion and disease prevention services.
Public Health Minister Dr Cholnan Srikaew emphasized that the UCS upgrade has transformed from "30-baht  Treating All Diseases" to "30-baht Treatment Anywhere" using only a national ID card. These changes involve reforming the health data system and initiatives to strengthen primary healthcare by maximizing existing healthcare resources.
As for reforming the health data system, the Ministry of Public Health has done quite well in unifying the data by linking patient information across health facilities while adhering to privacy and data security principles.

Regarding engaging the private sector, the National Health Security Office (NHSO), which oversees UCS, has facilitated a health provider registration system in which clinics can register in the database of the Department of Health Service Support and the Provincial Public Health Offices

To expand and strengthen primary healthcare services for UCS, the NHSO has collaborated with various professional councils in the health sector to integrate pharmacies, nursing and midwifery clinics, medical technology clinics, physical therapy clinics, dental clinics, general medicine clinics, Thai traditional medicine clinics, and telemedicine services. This initiative, recognized as the  'Innovative Health Service Unit, aims to provide services for the scheme and enhance the public's health literacy.

Apply neighborhood healthcare concept

Part of the UCS upgrade is to reinforce the concept of 'neighborhood healthcare,' which has been the UCS' primary goal for over twenty years. This is done by addressing the patients' pain points, particularly their hidden costs of going to hospitals, loss of daily income, and waiting times.
This principle is reflected in the scheme's requirement that its beneficiaries get services at designated health units, ideally near their residence. This is possible because Thailand has a well-structured public health system, in which a variety of service units, ranging from large hospitals to sub-district health-promoting hospitals, were established long before the beginning of UCS. 
The NHSO reimburses healthcare costs directly to health service providers, allowing patients to receive services without paying out of their own pockets. 
However, hidden costs still discourage people from seeking health services, including the traveling cost for patients to commute from home to hospitals and the loss of their income while spending days in health units. This challenge led the NHSO to reform the scheme by making health units closer to the people. "We already have a significant number of public sector service units distributed across all areas, but at the same time, there are considerable untapped resources in the private sector,” said Dr. Cholnan.
Dr Chalanan recounted the COVID-19 pandemic when the private sector significantly responded to the crisis. A clear example was observed through pharmacies, which helped distribute coronavirus self-test kits to communities, and the NHSO reimbursed the cost to pharmacies directly.
Even though the pandemic has eased, there have been inquiries from the public about whether they can continue to obtain medications from pharmacies for minor symptoms like fever, headache, and red eyes.
This prompted the NHSO to expand its partnership with pharmacies nationwide by involving them in distributing medications for 16 common illnesses and providing health promotion and disease prevention services such as making birth control pills and condoms available without charge.
This initiative has gained support from the Pharmacy Council of Thailand, which agrees that pharmacists can play a vital role in boosting people's access to healthcare.
 
Reduce congestion and waiting times

Waiting for medication in hospitals can consume patients' time, causing them to wait longer than necessary. Therefore, private pharmacies have been involved in solving this challenge.
Due to the partnership, hospitals can now organize patients' medications and send them to pharmacies partnering with the NHSO, or hospitals deposit medications at pharmacies and pharmacists dispense them according to physicians' orders.
This allows patients to collect medications from nearby pharmacies or enables pharmacies to purchase medicines based on a prescription list.
Meanwhile, the partnering nursing clinic can provide essential medical treatment to UCS beneficiaries, such as injections and wound cleaning. Previously, accessing such services might have required using emergency room space, primarily reserved for critical patients, causing those with minor ailments to wait.
Similarly, patients demanding blood tests may need to wait hours at hospitals. The NHSO has partnered with the Medical Technology Council to engage medical technology, allowing hospitals to reduce workload by referring patients to medical technology clinics for blood tests.
Access to dental care has also improved since the launch of the NHSO’s partnership. Dental services are typically costly and entail long hospital waiting times, especially for specialized dental procedures.
The engagement of private dental clinics in UCS offers quick access to general dental services such as cleaning, fillings, extractions, dental sealants, and fluoride vanishing.
“The head dentist at Phrae Hospital shared that since the implementation of this partnership, specialist dentists have been able to focus more on specialized tasks. This is because they can refer some patients who require basic services to clinics,” said Dr Cholnan. 
“Patients who visit the hospital are typically those requiring  specialized treatment. As a result, doctors can fully utilize their expertise and manage their time more efficiently.
 
Encourage health literacy

The partnership with both public and private clinics under the "Innovative Health Service Unit" can also help promote health literacy among the public.“People often search for health information on the internet. But the information found there is sometimes incorrect and false,” said Dr Cholnan.
The NHSO has collaborated with Doctor at Home, an online platform technology where the public can use AI to inquire about symptoms and various illnesses. This information is acquired from a database of over 400 diseases and can be accessed through the NHSO's Line official account.
Conversely, partnered health units provide health promotion and disease prevention services that help improve people's health literacy through health experts' advice and consultation. They promote self-care and self-testing that helps reduce the risk of patients developing severe diseases. For example, partnered pharmacies have distributed self-screening kits for cervical cancer prevention.
Additionally, the partnered physical therapy clinic addresses the issue of limited physical therapists in large hospitals with a high volume of service users. UCS beneficiaries with four symptoms, such as stroke, traumatic brain injury, spinal cord injury, and fragility fracture hip, can request services from the clinics. 
These patients have a golden period of six months for physical therapy treatment, which is considered the most effective recovery period and requires continuous care.
However, hospitals usually have a limited number of physical therapists, resulting in patient treatment delays. Partnering with clinics helps fill this gap, allowing patients to access care promptly.
"We learned from a physical therapy clinic in Phang Nga province that one clinic is responsible for nearly 30 patients and conducts multiple home visits. The staff ventured into the mangrove forest, showing the clinic's efforts in patient follow-up and helping them regain mobility after bedridden,” said Dr. Cholnan.
 
Significant Change in 20 Years

“This is seen as a major reform and a significant change in the healthcare system, 20 years after the introduction of UCS,” said Dr Cholnan.
This reform, which kicked off on January 7, is ongoing in 12  pioneering provinces, including  Phrae, Phetchaburi, Roi Et,  Narathiwat, Phetchabun, Nakhon Sawan, Sing Buri, Sa Kaeo, Nong Bua Lamphu, Nakhon Ratchasima, Amnat Charoen, and Phang Nga. Over 400 private health units have joined the pilot to support the UCS upgrade.
The NHSO will monitor access numbers and collect daily feedback to determine areas for improvement or problems to solve to move forward. The next step is to expand this initiative nationwide.
In the meantime, the NHSO has improved its reimbursement procedure to assure timely payment and clear payment cycles, creating confidence among private health units joining the partnership.
"During the initial phase of system adjustment, there were obstacles, as state agency payments needed to consider an auditing system that went hand in hand. What was considered quick was still not as fast as the private sector desired,” said the public health minister.
However, with the entire team's dedication, we were able to work collaboratively, and now payments are made every three days.