Starting July Next Year, 'Dementia Primary Care Physician' Introduced... Initially Targeting 20 Si-Gun-Gu Areas

A pilot project that allows dementia patients to receive systematic treatment and manage other diseases through their primary care physicians will be implemented starting July next year.

On the 12th, the Ministry of Health and Welfare held the 25th Health Insurance Policy Deliberation Committee meeting and announced that it discussed the promotion plan for the pilot project called ‘Dementia Management Primary Physician’ (tentative name). It explained that as the number of dementia patients increases in the aging era, the need for integrated medical services that can prevent overall health deterioration along with dementia symptoms and provide continuous management has grown. This year, the number of dementia patients is estimated to have surpassed 10% of the elderly population aged 65 and over.

The Dementia Management Primary Physician pilot project allows dementia patients to select doctors specialized in dementia treatment and management so that they can receive integrated management for multiple health issues such as chronic diseases. Neurologists, psychiatrists, or doctors who have completed dementia-specialized training will participate in the pilot project.

In the pilot project, services such as establishing patient-specific customized plans for dementia treatment and management, providing in-depth education and counseling, are each defined as health insurance fee-for-service acts. The purpose is to ensure that appropriate services are provided according to the patient's circumstances. The patient’s co-payment rate for the services is set at 20%. However, a 10% special calculation rate applies to patients with severe dementia.

The services of the pilot project will be provided starting July next year. Meanwhile, the Ministry of Health and Welfare plans to prepare a detailed plan for the pilot project within this year, conduct recruitment for project participation, provide pilot project training, and establish a computerized system for nursing care benefit claims. It will initially be conducted in 20 cities and counties, and plans to expand in 2025 depending on the participation level of medical institutions and patients.

A Ministry of Health and Welfare official stated, “The Dementia Management Primary Physician is expected to play a central role in community dementia treatment and management by conducting comprehensive assessments and establishing treatment and management plans for dementia patients, providing in-depth education counseling and home visits, and simultaneously linking and utilizing community medical and welfare resources such as dementia safety centers when necessary.”

Meanwhile, at the same Health Insurance Policy Deliberation Committee meeting, it was also discussed that the annual out-of-pocket medical expense ceiling for the poor will be frozen at this year’s level next year. The out-of-pocket medical expense ceilings for low-income groups in the first income quintile and the second to third quintiles were frozen at 870,000 KRW and 1,080,000 KRW respectively, reducing the medical expense burden for low-income groups. The Ministry of Health and Welfare expects that through this, 48,000 low-income individuals will receive a total additional benefit of 29.3 billion KRW.