Committee for Relative Value Reform to Operate from Second Half of the Year
The Ministry of Health and Welfare announced on the 18th that it will completely overhaul the current 'fee-for-service system.'
At a briefing of the Central Disaster and Safety Countermeasures Headquarters (CDSCH) responding to the doctors' collective action, Park Min-su, the 2nd Vice Minister of the Ministry of Health and Welfare, said, "The fee-for-service system has the advantage of high payment accuracy, but since revenue increases as the volume of services increases, it focuses on increasing the volume of various tests and treatments rather than the treatment outcomes. This has the disadvantage of failing to properly control treatment results and the increase in medical expenses."
As part of this, the current 'relative value fee system' will be completely revamped to establish a mechanism for rapid readjustment of relative values. First, the revision cycle of relative value scores will be shortened to two years, and thereafter, it will transition to an annual continuous adjustment system.
The government has been applying the 3rd relative value revision plan this year, which raises the compensation level for essential medical services in the field of severe surgeries. Going forward, the 4th relative value revision will be applied every two years, and during the 4th revision, inpatient care, surgery, and treatment in essential medical fields are planned to be significantly increased.
Additionally, to ensure evidence-based adjustment of relative value scores, guidelines for standard cost estimation will be prepared, and the number of panel hospitals used as the basis for cost estimation will be expanded from the current approximately 100 to a level capable of generating evidence. To carry out this relative value revision work, the government has formed a 'Medical Cost Analysis Committee' within the Health Insurance Policy Deliberation Committee, consisting of government officials, experts, and medical professionals, and after preparations in the first half of the year, it will be fully operational from the second half.
The Ministry of Health and Welfare reiterated its policy on the same day to invest more than 10 trillion won in essential medical care by 2028.
A total of more than 5 trillion won will be concentrated on compensation for surgical fields that are avoided due to high difficulty and workload, such as burn treatment, sujijeophap (digital replantation), pediatric surgery, transplant surgery, and severe internal medicine diseases such as cardiovascular and cerebrovascular diseases. Through this, essential medical fields with high difficulty and workload will be properly compensated.
A total of more than 3 trillion won will be concentrated in fields such as pediatrics and obstetrics, where demand has decreased due to low birth rates and other factors. For fields where treatment outcomes can be maximized through inter-institutional cooperation such as cardiovascular networks and severe pediatric networks, 2 trillion won in network compensation will be strengthened.
Vice Minister Park said, "The government has begun full-scale work for pinpoint compensation in essential medical fields, and detailed guidance will be provided as soon as specific compensations are decided."
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