National Health Insurance Administration (NHIA) Director General Shih Chung-liang on Nov. 4 said that a pilot program to implement hospital-specific global budgets will take effect this year, where each hospital will be given tiered caps on the number of medical points that can be claimed, which will if exceeded, could result in a medical point value of zero. Director General Shih said that the change is aimed at preventing over prescription of healthcare services and containing patient volume growth. He also hopes to see the new rules encourage hospitals to make adjustments so that inpatient care and outpatient care each account for 50% of claimed medical points to improve compensation for health professionals.

Director General Shih pointed out that although the National Health Insurance (NHI) global budget has increased annually, without the hospital-specific global budget cap, the growth rate of Taiwan’s hospital bed capacity will reach 14.63% over the next seven years, potentially pushing the NHI system toward insolvency and requiring higher NHI premiums.

On potential concerns such as patients being referred from one institution to another that may arise from the hospital-specific global budget system, Director General Shih said that the NHIA will set a reasonable medical service growth rate, as well as giving more weighting to inpatient care compared to outpatient care, adding that the NHIA has reached a consensus with Taipei region hospitals that caps will be exempted critical care so that hospitals will not turn away patients in need.

[2025-2-4/United Daily News]