Cost Drivers in Malaysia’s Medical and Health Insurance and Takaful Sector: A First Look at the Centralized Claims Database
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Washington, DC: World Bank
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Malaysia has seen sharp increases in Medical and Health Insurance/Takaful (MHIT) premiums in recent years, elevating affordability concerns and prompting a broad policy response. This report provides an empirical assessment of cost drivers in MHIT claims from 2022 to 2024. The central claims database consolidates claims submitted by licensed insurers and takaful operators and includes financial fields, clinical and administrative information. Using regression-based models, the analysis estimates service-level medical inflation by constructing price indices for comparable baskets of services. The report then decomposes spending growth into price, volume, intensity and setting-mix components to shed light on the channels driving up costs in MHIT. Finally, the report analyses selected efficiency measures to identify areas for immediate improvements.
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GOOD HEALTH, WELL-BEING, HEALTH INSURANCE, MEDICAL AND HEALTH INSURANCE/TAKAFUL (MHIT), HEALTH INSURANCE PREMIUMS, UNIVERSAL HEALTH COVERAGE