By National Health Insurance Administration Director General Lee Po-chang
While the Global Budget Payment System of Taiwan’s National Health Insurance (NHI) has been effective in managing the growth in annual expenditure, the amount of medical points claimed by health care providers each year has continued to exceed the annual global budget. As a result, the value of each medical point has faced devaluation each year. The National Health Insurance Administration will face this challenge and reassess the management of the NHI in accordance with the recommendation of clinical professionals.
Looking ahead, authorities will strengthen the implementation of the referral system and establish new copayment requirements for inpatient visits, drug prescriptions and diagnostic tests, as well as establishing new caps on each copayment item so that each beneficiary contributes a basic copayment. In addition, authorities will continue to consult the medical community on more reasonable guidelines that places more importance on the diagnosis of doctors and physicians, as well as increasing the amount of medical points awarded to those who care for critical patients.
During the pandemic, virtual consultations were made available in accordance with the “Rules of Medical Diagnosis and Treatment by Telecommunications,” with a review to be conducted to determine whether telemedicine will be covered under the NHI reimbursement scheme. In line with Taiwan’s digital development strategy, a “virtual NHI card” is being planned to facilitate the work of health care professionals.
Authorities will also continue to work with the Insurance Bureau in encouraging insurers to develop products that cover gaps in the NHI. Authorities will open access to NHI data to insurers to aid in the development of new products to maximize the value of the data.
Matching the NHI’s growing expenses with continued increase in premiums is not a viable long-term solution. Following advancements in artificial intelligence, precision medicine, new drugs, medical devices and technologies, the efficiency of the NHI can be improved.
[2021-10-24/Liberty Times]
