Page 109 - 2023 Taiwan Health and Welfare Report

08 National Health Insurance and National Pension 08

Figure 8-3 Reserve Fund, Before and After Implementation of the Second-Generation NHI

100 million
3,000
2,474
2,500 2,289 2,376
2,109
2,000 1,767
1,500 1,260
1,091
1,049
936
1,000 746
500
210
-55
-
-265
-397
-582
-500
-1,000 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 Year

The adjustment of premium rate
April 2010 The implementation of the January 2016 January 2021
Second-Generation NHI in
●The general ●The general premium ●The general premium rate
January 2013.
premium rate was rate was decreased from was increased from 4.69%
increased from ●The general premium rate was 4.91% to 4.69% to 5.17%.
4.55% to 5.17%. decreased from 5.17% to 4.91%. ●The supplementary ●The supplementary
●NHI began to collect the premium rate was premium rate was increased
supplementary premium, and decreased from 2% to from 1.91% to 2.11%.
the rate was 2%. 1.91%.
Source: National Health Insurance Administration, MOHW (NHIA)
the growth in medical expenses, the Global Budget total of 81,000 people were provided with care services
Payment System was introduced in 2002 and this during the course of 2022.
has kept the annual growth in medical expenditure at Post-Acute Care (PAC) program established "PAC
approximately 5%. In addition, the payment strategies, Teams" at medical centers (only for heart failure), regional
such as case payment and pay for performance (P4P) and district hospitals for the treatment of stroke, burn,
were implemented to change medical practice and traumatic nerve injury, fragility fracture, heart failure and
enhance the quality of medical services. In 2010, the frail senior patients. PAC Teams provide such patients
Taiwan Diagnosis Related Groups (Tw-DRGs) were first with integrated care during the golden treatment period
implemented, with phase 2 continuing in 2014. such as intensive and regular physiotherapy, occupational
The "NHI High-utilization Patient Counseling therapy, and language therapy as well as social workers
Program" provided counseling to people that made and nutritionists. A total of 38 teams and 225 hospitals are
more than 90 outpatient visits in the preceding year. If currently in the program. More than 62,000 cases were
there was no significant improvement after one year of accepted at the end of 2022. In 80% of the patients, clear
counseling and the user was determined by a review progress was made in their function, over 80% of patients
physician to be engaging in abnormal seeking of medical returned home smoothly.
care, no payments will be made unless they seek In order to facilitate ongoing, reasonable review
treatment at designated institutions (except in the case of fee schedule, the budget allocation for 2022 in the
of emergency). After receiving guidance throughout Hospital Global Budget sector aims to "enhance critical
2022, high-utilization cases from 2021 (year of medical care expenses, foster structural changes in outpatient and
visits) experienced an average decrease of 16.48% in inpatient services within regional hospitals and medical
healthcare visits. This reduction resulted in a cost savings center," as well as "promote the development of tiered
of approximately NTD 345 million. medical system and strengthen district hospitals." The
The Integrated Home Care Plan had 225 teams at objective is to elevate critical care expenses, ensure
the end of 2022 including 3,178 medical institutions. A fixed-point valuation for inpatient diagnostic fees and

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