With tens of thousands of people seeking treatment for breast cancer each year, the government has allocated about NT$40 million (US$1.25 million) to improve treatment quality, Minister of Health and Welfare Shih Chung-liang (石崇良) told a news conference yesterday.
Citing National Health Insurance (NHI) data, Shih said that about 180,000 people seek treatment each year, which add up to about 21.228 billion NHI points (one point usually equals NT$0.9 to NT$1) of medical expense and 9.88 billion NHI points of drug expense per year.
To improve healthcare quality and reduce the mortality rate of breast cancer, the ministry last year announced that a “pay for performance” (P4P) strategy — a model rewarding healthcare providers with financial incentives for meeting specific quality, efficiency and health outcome metrics — would be implemented this year.
Photo: Hou Chia-yu, Taipei Times
Shih, along with NHI Administration Director-General Chen Lian-yu (陳亮妤) and representatives from the Taiwan Breast Cancer Society, yesterday announced the official launch of the P4P Breast Cancer Care Quality Improvement Program.
“Breast cancer care is a national challenge that cannot be overlooked, as breast cancer is the most common cancer and the second-leading cause of cancer deaths among women,” Shih said.
Early diagnosis is a key factor to reducing the mortality rate, he added.
The overall five-year survival rate for breast cancer is relatively high compared with many other types of cancers, he said.
If discovered at stages 1 and 2, the survival rate is more than 90 percent, but this drops significantly when the disease reaches stages 3 and 4, with only about 40 percent for the latter, he said.
The WHO’s Global Breast Cancer Initiative has set a goal to improve early detection and diagnosis of breast cancer, with the key performance indicator being at least 60 percent of invasive breast cancers being diagnosed and treated at stage 1 or 2, he said, adding that Taiwan’s is more than 70 percent.
However, screening is not enough to reduce the mortality rate, so improved quality of care is needed at the same time, he said.
The P4P program aims to gradually transform the medical payment from a “fee-for-service” model to a “value-based” model, he said.
In line with the WHO’s initiative, the program also aims to have more than 60 percent of breast cancer patients diagnosed and treated at stage 1 or 2, limit the time between the first diagnosis to treatment within 60 days, and provide comprehensive and integrated care, he said.
Chen said the P4P program is expected to bring about substantial benefits in three aspects: quality assurance, value-based rewards and NHI sustainabililty.
People are used to seeking famous doctors at large hospitals because of concern over treatment quality, but the P4P program is to assure them that if they seek treatment at hospitals that are members of the program, they will received standardized quality care, she said.
The program’s value-based rewards for hospitals and healthcare providers allow doctors to focus on pursuing excellence in treatment, rather than on number of patient visits, she said.
Additionally, the program focuses on early diagnosis, precision medicine and effective management, ensuring that NHI resources create maximum value, she said.
The P4P program’s target clients include newly diagnosed or first-recurrence breast cancer patients at any stage, and the NHIA has allocated about NT$40 million to encourage healthcare facilities to join the program and provide continuous quality care following the latest treatment guidelines, Chen said.
Additional reporting by CNA
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