189828 Cost-containment measures of Taiwan, NHI

Monday, October 27, 2008: 12:50 PM

Shu-Cheng Liang, MS , Department of Health, The Executive Yuan, Taipei City ,Taiwan,(R.O.C.), Taiwan
The National Health Insurance (NHI) Program in Taiwan is a mandatory government-run social insurance system which covers 99% of the population. Since its inception in 1995, NHI has been facing the challenges of rapid increase on health care costs, particularly in 1998; nominal growth rate of NHI costs reached 11.4% per year. Many strategies have been considered and introduced in controlling costs and in improving quality of care. Among them the Global Budget Payment System (GBPS) and the increase of co-payment were the most important reforms.

The GBPS is a prospective payment system which usually determines annual budget for a specific sector prospectively through negotiation. In 1998, dentistry was the first professional group to initiate the GBPS. Hospitals joined in at last in 2002. The NHI was able to reach a controlled health expenditure since then.

Besides the GBPS and co-payment adjustments, Taiwan has introduced a variety of cost containment strategies, including various price-regulations for drug and medical services, and case payment…etc.

Today, total NHI costs were controlled within a stable range. The nominal annual growth rates on per capita costs (budget) ranged 3.6- 4.2 % from 2002 to 2008. The GBPS has proved to be effective on cost control and on enhancing responsibility of the providers for self-management. Further, the unit of payment and other micro strategies such as quality-based payment system are introduced following global budget payment system to improve efficiency and quality of care.

Learning Objectives:
1. Analyze the current payment system and problems which led to the payment system reform in Taiwan. 2. Discuss the design and impacts of the implementation of the Global Budget Payment system on costs and quality of care during the past ten years.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: not provided
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.