As digital health continues to develop rapidly, Dr Shih Chung-Liang, the Minister of Health and Welfare (MOHW), announced that the MOHW is planning to include digital health in the National Health Insurance (NHI) temporary payment scheme. Additionally, the assessment for the reimbursement of AI-assisted diagnostic tools is expected to be completed soon. To regulate the self-pay healthcare market, the MOHW will launch the 'National Information Platform for Healthcare Fee Charges' by the end of this year. This platform will assist local health authorities in verifying the pricing of emerging medical tools, thereby promoting their clinical use.
The Bio Taiwan Committee Convention was held on the 26th with the theme of 'Healthy Taiwan,' focusing on digital health and industry development. Participants suggested providing temporary payment for qualified AI-assisted healthcare products, either through the NHI or other special funds. This approach is expected to enhance healthcare quality and encourage industry growth. The MOHW Minister pledged to consider this suggestion.
Dr Shih Chung-Liang, the Director-General of the BNHI, acknowledged that digital health poses certain challenges for the NHI. For instance, should digital health tools be classified as medical devices or medical services? How should their clinical benefits be evaluated, and how should economic analysis be conducted? What is their relationship with clinical outcomes? Should the payment method be a bundled payment or based on payment-by-service?
Dr Shih Chung-Liang noted that the NHIA is considering offering temporary payments for certain digital health tools, such as AI-assisted diagnostic software, wearable devices, and telemedicine communication equipment, provided that their diagnostic accuracy and clinical impact are supported by real-world evidence (RWE). During the temporary payment period, manufacturers will be required to gather evidence on healthcare quality and efficiency. The NHIA will then assess this new evidence to determine whether the product should be formally included in the NHI scheme.
Last year, the NHI approved payment for an AI-assisted medical device capable of providing an early warning 15 minutes before hypotension occurs in patients at high risk during anesthesia for surgery. Currently, the NHIA is evaluating the financial impact of various AI-assisted diagnostic tools on the NHI, including AI-assisted interpretation of intracranial hemorrhage in computed tomography, AI-assisted bone marrow cell type interpretation combined with cell classification counting, and ultrasonic intelligent analysis of thyroid nodules. This analysis is expected to be completed by the end of the year, with the results serving as a reference for future NHI reimbursement decisions.
Regarding new health technologies not yet included in the NHI Benefit Scheme, Dr Shih explained that, according to Article 21 of the Medical Care Act, it is the responsibility of local health authorities to approve fee charges. However, this presents challenges for local authorities due to the lack of clinical evidence and the absence of consistent assessment standards.
To address this issue, Dr Shih revealed that the NHI is planning to launch a platform aimed at improving and streamlining the assessment of healthcare products in the self-pay market. This project consists of two parts. First, local authorities will be required to upload all approved products or technologies, along with their approved prices, onto the platform, allowing other local authorities to reference them. Second, for innovative medical devices or technologies that do not yet have a corresponding healthcare service item, the NHIA will manage the application process. This platform is intended to accelerate assessment procedures, said Dr Shih.
【2024-08-27/ Liberty Times】
