Taiwan Considers Major Increase in Medical Center Co-Payments

The cost of visiting medical centers in Taiwan may rise significantly in the coming year. According to a statement from the National Health Insurance Administration (NHIA), the co-payment for individuals visiting large hospitals without a referral could increase from NT$420 to NT$1,200 (approximately US$39.18). This proposal is seen as a “last resort” aimed at prioritizing larger medical facilities for critical and complex cases, as outlined by Liu Lin-i, Director of the NHIA Medical Affairs Department.

The proposed increase would reflect half of the average insurance reimbursement for outpatient visits at medical centers, which is around NT$2,400. Liu indicated that a review of the co-payment adjustment is scheduled for July 2024. This assessment will depend on the effectiveness of a newly implemented reimbursement cap designed to manage outpatient visits at medical centers.

The reimbursement cap, introduced incrementally throughout the year, limits insurance payouts for outpatient services to a maximum of 55 percent of a medical center’s total revenue. Liu emphasized that this measure aims to allocate resources more efficiently, focusing on severe health issues rather than minor ailments. The NHIA intends to negotiate further adjustments to this percentage based on feedback from the medical community.

As part of this initiative, the NHIA plans to launch a public information campaign to encourage compliance with government policy. Liu stated that large hospitals should concentrate on treating critical illnesses, injuries, and specialist therapies, including chemotherapy and radiation. He noted that prioritizing care for severe diseases represents the most effective use of resources within medical centers.

The NHIA’s efforts are designed to reinforce a tiered healthcare system and ensure that medical centers are available for those in critical need. The anticipated changes reflect a broader strategy to restructure healthcare access in Taiwan, aiming for both efficiency and improved patient outcomes.