The Private Hospital Association (PHA) yesterday stood firm on its demand that the Social Security Office (SSO) must raise the reimbursement rate for the cost of an inpatient with expensive disease care to 15,000 baht per case.
Dr Chalerm Harnphanich, a former president of the PHA, said on Thursday after the first meeting of a special subcommittee on the criteria and payment rates to contract hospitals under the Social Security System (SSS) that the average medical costs endured by the hospitals have always been higher than the rate the SSO reimburses.
Regarding Labour Minister Phiphat Ratchakitprakarn's earlier vow to push for an increase in the reimbursement rate of inpatient care to 12,000 baht per case, Dr Chalerm said such a rate does not match the reality.
The minister's pledge came last week after at least 70 private hospitals expressed their intention to terminate their contract with the SSO by the end of this year unless it adjusts the payment rates.
They claimed the reimbursement rates had not been updated for five years and, in some categories, the fund had even been reduced.
Dr Chalerm said the actual cost of medical care for inpatients with expensive-to-treat diseases at private hospitals has been on the rise since 2020.
The PHA suggested the SSO base its calculation of the reimbursement rate for private hospitals on actual costs, not on the state-run hospitals, he said.
According to Dr Chalerm, the average cost for inpatient medical care at a state-owned hospital is 13,800 baht per case, while that at a medical school hospital is 30,000 baht.
He said both sides agreed in principle at yesterday's meeting that any rates below 12,000 baht were unacceptable, and the PHA has made an initial request for a 15,000-baht base rate per case.
He said that even if the reimbursement rate is adjusted to 15,000 baht, the amount would still barely cover the actual costs of treating certain diseases.
The next meeting of the sub-committee has been set for Oct 29 and will also focus on details on the medical costs.
