Pediatrics, Obstetrics, and More Receive Over 3 Trillion Won
"Ensuring Proper Compensation for High-Difficulty, High-Intensity Essential Medical Fields"
The government announced on the 18th that it will invest more than 10 trillion won in essential medical care by 2028, with half of that amount, 5 trillion won, being concentrated on under-served surgical fields and severe internal medicine diseases such as cardiovascular and cerebrovascular diseases.
Park Min-su, Vice Minister of Health and Welfare, stated at a briefing held at the Government Seoul Office in the morning during the Central Disaster and Safety Countermeasures Headquarters (CDSCH) meeting on doctors' collective action, "We have begun full-scale work on pinpoint compensation for essential medical fields."
Last month, the government announced the 'Essential Medical Care Policy Package,' pledging to invest more than 10 trillion won by 2028.
On this day, the government said it would provide concentrated compensation of more than 5 trillion won for surgical fields that are avoided due to high difficulty and workload, such as burn treatment, finger replantation, pediatric surgery, and transplant surgery, as well as severe internal medicine diseases like cardiovascular and cerebrovascular diseases. The aim is to ensure that essential medical fields with high difficulty and workload receive proper compensation.
More than 3 trillion won will be invested in fields such as pediatrics and childbirth, where demand has decreased due to low birth rates and other factors. For areas where treatment outcomes can be maximized through inter-institutional cooperation, such as cardiovascular and cerebrovascular networks and severe pediatric networks, 2 trillion won will be allocated to strengthen network compensation.
Additionally, the government plans to innovate the 'fee-for-service system,' which forms the basis of health insurance fees, into a 'value-based payment system.'
The fee-for-service system sets a unit price for each individual medical act and pays through health insurance finances. While it has the advantage of payment accuracy, it has been criticized for encouraging excessive treatment because revenue increases with the volume of services provided. Vice Minister Park said, "It focuses more on increasing the volume of various tests and procedures rather than treatment outcomes, which leads to shortcomings in properly controlling treatment results and medical expenses." He added, "We will continuously explore and actively introduce an 'alternative and innovative payment system' based on performance or value that rewards final health outcomes and integrated health management rather than service volume."
The government plans to fully activate the 'Medical Cost Analysis Committee,' which includes government officials, experts, and medical professionals within the Health Insurance Policy Deliberation Committee (HIPDC), from the second half of this year to reform the relative value scale used to calculate fee-for-service payments. The relative value score is the price for each medical act that forms the basis of fee-for-service payments. It can be broadly divided into five categories: surgery, hospitalization, treatment, imaging, and testing. Surgery, hospitalization, and treatment fees have been undervalued, while imaging and testing have been overvalued, and the government intends to correct these issues.
Vice Minister Park said, "Because the resource consumption required for treatment was used as the standard, compensation for tests using equipment has become larger than for medical acts performed by experienced healthcare professionals." He added, "Although the relative value scores have been revised three times?in 2012, 2017, and 2024?conflicting interests among different fields have hindered smooth adjustments from overvalued to undervalued items."
He also noted, "The Korean Medical Association, which was delegated the authority to estimate workload?a core part of determining relative value scores?failed to coordinate internally, worsening imbalances among medical specialties. The revision cycle for relative value scores was extended from five to seven years, which delayed timely reflection of changes in the medical environment. Moreover, relative value scores were influenced more by the interests of specialized fields than by analyses of medical costs."
He explained, "To address these issues, we will significantly reform the procedures and methods for calculating relative value scores. The revision cycle will be shortened to two years, followed by a transition to an annual continuous adjustment system."
He continued, "The third revision of the relative value scale is being applied from this year, and the fourth revision will be applied every two years going forward. During the fourth revision, fees for hospitalization, surgery, and treatment in essential medical fields will be substantially increased."
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