National Health Insurance outpatient co-payments for people visiting large hospitals for minor health issues without a referral could increase significantly later next year, an official said yesterday.
A proposal to raise the nonreferred co-payment at medical centers to NT$1,200 (US$39.18), from NT$420 is regarded as a “last resort” to reserve larger medical centers for critical and complex cases, National Health Insurance Administration (NHIA) Medical Affairs Department Director Liu Lin-i (劉林義) said.
The proposed hike would amount to half of the average insurance reimbursement for a medical center outpatient visit, which is about NT$2,400, Liu said.
Photo: Taipei Times
Liu said that an assessment on whether to increase the co-payment would be conducted in July next year, but only if a review determines the “reimbursement cap” measure fails to ease outpatient visits at medical centers in the first half of the year.
Introduced incrementally by region this year, the measure caps insurance reimbursement for outpatient services, aiming to limit resources hospitals dedicate to minor health issues and to reinforce the tiered healthcare system, the agency said.
Under this measure, a medical center’s reimbursement for outpatient services is capped at 55 percent of the institution’s total revenue, Liu said.
The agency hopes to further lower this percentage, pending negotiations with the medical community, he said, adding that it would allow a six-month trial period to assess whether the measure produces the desired results.
Large hospitals should prioritize treating critical illnesses, and injuries and specialist therapies, including chemotherapy, radiation and outpatient parental anti-microbial therapies, he said, adding that treating severe diseases is the best use of medical centers.
The NHIA would accompany the prioritized medicine initiative’s rollout with a public information campaign to prompt Taiwanese into voluntarily complying with government policy, he said.
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