The NHIA reviewed the implementation results of the new tariff for NHI co-payments on drugs and A&E services introduced in July 2023. The data shows a slight increase in demand for treatments at primary care clinics and a reduction in demand for A&E treatments at hospitals. The new co-payment system generated an additional income of NT$5.27 billion. However, the Taiwan Healthcare Reform Foundation (THRI) argues that the new system neither achieves its objective of controlling quantity through higher prices nor improves the tiered healthcare system. Dr Shih Chung-Liang, Director-General of the NHIA, noted that the increase in visits to primary care clinics and the decrease in average drug fees for repeated prescriptions for chronic diseases are both positive outcomes. The NHIA will study the possibility of imposing co-payments on medical exams, such as CT and MRI.

The new NHI co-payment system has been in effect since July 2023, raising the co-payment for drug fees to NT$300 at regional hospitals and medical centers, and the co-payment for A&E services to NT$400 at regional hospitals and NT$750 at medical centers.

The NHIA recently published the data collected since the implementation of the new co-payment system. The proportion of outpatient visits to primary care clinics rose from 70.17% to 70.39%, a 0.22% increase. The average drug fees for repeated prescriptions for chronic diseases decreased from NT$884 in 2022 to NT$842 in 2024. Payment fairness also improved, as the proportion of medical costs covered by co-payments increased: from 13.9% to 16.1% in medical centers, from 10.4% to 12.2% in regional hospitals, and from 5.6% to 6.7% in district hospitals, with no changes in primary care clinics. Overall, the new co-payment system generated additional revenue of NT$5.27 billion for the NHI.

Dr Shih acknowledges the positive effects of the increased co-payment. After just one year, some short-term results have emerged, such as improvements in tiered healthcare and reductions in drug waste. 

Dr Shih emphasized that these are just preliminary results. The NHI will promptly adjust the system based on a longer-term assessment. He also indicated that co-payments could be imposed on medical exams, such as CT and MRI, whose usage has increased significantly over the past few years.

【2024-10-25/ SETN news】