The NHIA announced the final phase of the implementation of the “Hospital Individual Global Budget System,” which will be rolled out in the Taipei region in the second quarter of this year. In response to the financial impact of the new system, many medical centers are considering various measures to mitigate the effects, including increasing registration fees, reducing weekend and nighttime outpatient services, and postponing non-emergency surgeries. NTUH emphasized that raising registration fees would be considered only as a last resort.
The tiered healthcare system has not been functioning as intended. As a result, big hospitals are handling an excessive number of cases of ailments. To control the outpatient service volume in big hospitals, the NHIA introduced the “Hospital Individual Global Budget System,” which has been implemented region by region. Under this system, hospitals are required to keep their NHI service volume below the previous year’s level; otherwise, any excess will either be reimbursed at a reduced rate or not reimbursed at all. The Taipei region is the last to implement this system due to its high concentration of medical centers serving patients from across the country.
At present, NTUH charges NT$100 for registration and NT$420 for the NHI co-payment. Dr. Chen Yen-Yuan, NTUH's spokesman, noted that the hospital is under pressure from rising medical expenses and drug prices. Although the NHIA raised the point value to NT$0.9 last year, it remains insufficient to cover overhead costs and personnel expenses. NTUH is considering various measures to mitigate the financial impact of the new individual global budget system. An increase in registration fees is one option, but it will only be considered as a last resort.
NTUH will encourage popular doctors who see over 200 patients in a single clinic session to treat patients at branches outside Taipei to help redistribute service volume. Dr. Chen stated that the ultimate solution is the full implementation of the tiered healthcare system.
Dr. Hung Tze-Jen, Vice Superintendent of Shin Kong Memorial Hospital, stated that the hospital is beginning to review potential cost-control measures while assessing the impact. However, no actions will be taken for the time being. The measures under consideration include increasing registration fees, reducing weekend and nighttime outpatient services, limiting the number of patients, and postponing non-emergency surgeries.
Dr. Hsu His-Hsien, Vice Superintendent of Mackay Memorial Hospital, noted that Mackay does not turn away patients and, therefore, will not impose a service volume cap for each department. He emphasized that hospitals have a duty to fulfill. However, Mackay will strictly enforce the referral system, ensuring that referred patients are transferred back to their original hospital once their condition stabilizes.
【2025-03-10 / China Times】
