Page 119 - 2022 Taiwan Health and Welfare Report

▏Section 3 Improving Finances by Establishing a Linkage
Mechanism between Revenues and Expenditures
For the sustainability of national health insurance, the Second-Generation NHI began to collect supplementary premium and increase government contributions to bring premium collection in line with the ability to pay principle and improve the financial shortfall. As the end of 2021, the balance over the years was NTD 93.6 billion as shown in Figure 8-3.
The Second-Generation NHI put in place the "National Health Insurance Financial Balance and Revenue / Expenditure Linkage Mechanism" that routinely reviews premium rate annually. To take into consideration the affordability, medical environment and NHI finance, it was recommended that starting from January 1, 2021, the general premium rate would go back to that before the Second-Generation NHI at 5.17%(with the supplementary premium rate link adjusted to 2.11%). The rate will be reviewed depending on economic recovery in the future.
▏Section 4 Diverse Payment Methods and Rational Management
The main payment method for NHI medical 08 services has been "Fee-for-Service (FFS)".
To effectively control the growth in medical
expenses, the Global Budget Payment System
was introduced in 2002 and this has kept
the annual growth in medical expenditure at approximately 5%. In addition, the payment
strategies, such as case payment and pay-for- performance (P4P) reform were implemented
to change medical practice and enhance the
quality of medical services. In 2010, the Taiwan
Diagnosis Related Groups (Tw-DRGs) were first implemented, with phase 2 continuing in 2014.
The "NHI High-utilization Patient Counseling Program" provided counseling to people that made more than 90 outpatient visits in the preceding year. If there was no significant improvement after one year of counseling and the user was determined by a review physician to be engaging in abnormal seeking of medical care, no payments will be made unless they seek treatment at designated institutions (except in
100 million 3,000 2,500 2,000 1,500 1,000
500 - -500 -1,000
2,289 1,260
2,474 2,376
2,109
1,091
2020 2021 (at the end of Year) January 2021
• General premium rate increased to 5.17%
• Supplementary premium rate increased to 2.11%
Figure 8-3
Reserve Fund, Before and After Implementation of the Second-Generation NHI
-265
2008
-582
2009
-397 -55
2010 2011
2012
2013 2014 2015
2016
2017
2018 2019
746 210
936
1,767
Premium rate adjustment
April 2010
• General premium rate increased from 4.55% to 5.17%
January 2013, implementing the Second-Generation NHI.
• General premium rate decreased from 5.17% to 4.91%
• NHI began collecting the supplementary premium (rate of 2%)
January 2016
• General premium rate lowered from 4.91% to 4.69%
• Supplementary premium rate lowered from 2% to 1.91%
Source : National Health Insurance Administration, MOHW (NHIA)
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National Health Insurance and National Pension