ASIA REGIONAL DRG WORKSHOP AND KNOWLEDGE EXCHANGE

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สำนักพัฒนากลุ่มโรคร่วมไทย

24 Jun 2025

The workshop, co-hosted by the World Bank and Thai CaseMix Center (TCMC), is designed to have global experts present international experience and solutions and for participant countries to share their experience, achievements and challenges.

Background
The Diagnostic Related Group (DRG) payment mechanism has been adopted or is being developed in several middle-income Asian countries. During the development and implementation of DRG payments, various challenges can be encountered and innovative solutions must be found. Regular meetings allowing
DRG technical and policy experts to share experiences, achievements, and challenges can facilitate knowledge exchange and accelerate the resolution of these issues.
Before the COVID-19 pandemic, three Southeast Asia DRG workshops were conducted. These workshops brought together national experts involved in DRG reforms and global experts on DRG payments to share knowledge and learning. There is significant interest in resuming these workshops.

Topics
The workshop is proposed to last for two days.
Day one (June 23, 2025): Contents focused on policy issues related to overall budget control in a DRG system.
Day two (June 24, 2025): Contents focused on technical issues related to claims review in a DRG system.

The presentations on global experience, regional experience and opportunities for other countries to respond/critique/ask questions will be intermixed, partly due to time differences between where presenters are located in the world and partly to stimulate more discussions throughout the day as learning takes place.

*DAY 1 - JUNE 23: OVERALL BUDGET CONTROL IN A DRG SYSTEM*
08:30-09:00	Registration
09:00-09:10	Opening remarks Melinda Good, Division Director for Thailand and Myanmar, WB
09:10-09:40	Introduction: Objectives and organization of the workshop, participant introductions
09:40-10:10	DRG payment in the health financing landscape and cost containment theoretical framework Presenter: Victoria Fan, Global Engagement Unit on Health Financing, WB (online)
10:10-10:25	Q&A
10:25-11:00	BREAK
11:00-11:30	Thailand experience: Global budget Presenter: Weraphan Leethanakul, Deputy Secretary-General, NHSO
11:30-12:00	China experience: Experience implementing DRG with global budget Presenter: Hongqiao Fu, Assistant Professor of Health Economics and Policy, School of Public Health, Peking University, China
12:00-12:30	Q&A
12:30-13:30	LUNCH
13:30-14:00	Australia experience: Design and implementation of overall budget control in Australian DRG system Presenter: Rick Marshall, Health Service Management Information Development and Activity Based Funding Adviser, Australia
14:00-14:15	Q&A
14:15-14:35	Mongolia experience: New introduction of overall cost containment Presenter: Batbayar Ankhbayar, MoH DRG Consultant, Mongolia
14:35-14:55	Indonesia experience: Considerations in the process of developing a cost containment strategy Presenter: TBC
14:55-15:30	Q&A
15:30-16:00	BREAK
16:00-16:45	Structured discussions & dialogue Facilitator: Sarah Bales, Uranchimeg Tsevelvaanchig, WB
16:45-17:00	Key take-aways from the day’s discussion; synthesizing some key principles to do and pitfalls to avoid during design and implementation of cost containment mechanism. Facilitator: Sarah Bales, WB
18:30-20:00	DINNER RECEPTION

*DAY 2 - JUNE 24: CLAIMS REVIEW IN A DRG SYSTEM*
09:00-09:30	Global experience in DRG claims review Presenter: Xiaohui Hou, Global Engagement Unit on Health Financing, WB (online)
09:30-09:45	Q&A
09:45-10:15	Unsupervised ML for explainable healthcare fraud detection Presenter: Shubhranshu Shekhar, Brandeis University, USA (online)
10:15-10:30	Q&A
10:30-11:00	BREAK
11:00-11:20	Indonesia experience: Development of care pathways, challenges when using “black box” grouper Presenter: TBC
11:20-11:40	Mongolia experience: Automated claims review and use of UpToDate Presenter: Delgerekh Sainjargal, GAHI Consultant, Mongolia
11:40-12:10	Australia experience: Measures to monitor and facilitate quality outcomes (readmissions, hospital acquired complications, mortality) Presenter: Rick Marshall, Health Service Management Information Development and Activity Based Funding Adviser, Australia
12:10-12:30	Q&A
12:30-13:30	LUNCH
13:30-14:15	Thailand experience: Claim Review and Audit System Presenter: Chaiyos Kunanusont, Senior Advisor, National Health Security Office, Thailand
14:15-14:30	Q&A
14:30-14:45	China experience: Cost and quality enhancement through claims review Presenter: Jingjing Lang, National Health Development Research Center, China
14:45-15:15	Q&A
15:15-15:45	BREAK (online survey)
15:45-16:30	Structured discussions & dialogue Facilitator: Sarah Bales, Uranchimeg Tsevelvaanchig
16:30-17:00	Interest in further knowledge sharing workshops or other activities Facilitator: Uranchimeg Tsevelvaanchig
17:00-17:30	Key take-aways from the day’s discussion; synthesizing some key principles for claims review and quality control Facilitator: Sarah Bales

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ASIA REGIONAL DRG WORKSHOP AND KNOWLEDGE EXCHANGE