Taiwan Proposes Co-Payment Increase for Non-Referred Hospital Visits

The cost of visiting large medical centers in Taiwan could rise significantly next year for those seeking treatment for minor health issues without a referral. According to an official from the National Health Insurance Administration (NHIA), the proposed increase in non-referred outpatient co-payments aims to prioritize large hospitals for more critical cases.

Liu Lin-i, the Director of the NHIA Medical Affairs Department, announced that the co-payment could jump from NT$420 (approximately US$13.80) to NT$1,200 (around US$39.18). This proposal is considered a “last resort” as the administration seeks to ensure that larger medical centers focus on treating complex and severe health issues, rather than minor ailments.

An assessment regarding the co-payment increase is scheduled for July 2024. This review will only take place if an earlier measure, aimed at capping insurance reimbursements for outpatient visits, does not yield the desired results in the first half of the year. This cap currently limits reimbursements to 55 percent of a medical center’s total revenue from outpatient services, which averages around NT$2,400 per visit.

The NHIA introduced this cap incrementally across different regions this year. The goal is to manage the allocation of resources in hospitals and reinforce a tiered healthcare system. Liu emphasized that large hospitals should concentrate on treating serious conditions, such as critical illnesses and injuries, along with specialized treatments like chemotherapy and outpatient parental anti-microbial therapies.

To complement this initiative, the NHIA plans to launch a public information campaign designed to encourage voluntary compliance among Taiwanese citizens with the government’s healthcare policies. Liu stated that the focus on serious diseases represents the most effective use of medical center resources.

As Taiwan navigates these proposed changes, the NHIA aims to balance healthcare accessibility with the need to prioritize serious medical conditions, ensuring that patients receive appropriate care based on their specific health needs.