The Ministry of Health and Welfare yesterday implemented changes to National Health Insurance (NHI) fees for outpatient visits to medical centers and visits to emergency rooms for less urgent conditions.
The ministry introduced a new payment mechanism to ameliorate issues with the hospital classification system and the patient referral information system, which officals say have been crippled by the public’s habit of directly seeking treatment at medical centers, even for less urgent conditions.
Co-payment outpatient fees for visiting a medical center without a referral from a clinic or district or regional hospital have increased from NT$360 to NT$420. However, if patients have a referral, the fee has been reduced from NT$210 to NT$170.
If patients seek emergency-room treatment for an illness or injury that is classified from “level three” to “level five” in seriousness, they must now pay an additional NT$100.
National Health Insurance Administration Director-General Lee Po-chang (李伯璋) yesterday visited Shin Kong Wu Ho-Su Memorial Hospital in Taipei to observe the implementation of the mechanism.
A few patients said that because of the higher medical fees, they might consider going to district hospitals or clinics, but several others said that they are used to seeing a particular doctor and are willing to pay an extra fee to continue being treated by them.
There are about 1 million outpatient visits per day, the administration said.
In 2006, 8.4 percent of all visits to treatment facilities were to medical centers, while 10.2 percent were to regional hospitals, the administration said, adding that by 2020, the percentages are expected to increase to 11.5 percent and 15.2 percent respectively, so the changes are necessary to improve the situation.
The NHI co-payment fees for outpatient visits have not been modified for more than a decade and the changes are not aimed at increasing NHI profits, but improving the hospital classification system so that medical resources are used more efficiently, and patients with critical illnesses can get the emergency treatment they need in time, Lee said.
Critical condition
‧ Non-referred outpatient co-payment fees have increased to NT$420.
‧ Referred outpatient co-payment fees have decreased to NT$170.
‧ Illness or injury treatment classified from “level three” to “level five” will incur an additional NT$100 fee.
‧ The move is aimed at improving emergency room efficiency so critically ill patients can be prioritized.
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