(Health Korea News / Lee Chang-yong) The National Health Insurance Corporation announced that it will ease the burden of medical expenses and expand support for the underprivileged.
Jeong Gi-seok, Chairman of the National Health Insurance Service (NHIS), reported on the progress of the HIS’s major tasks at the plenary session of the Health and Welfare Committee held at the National Assembly on the 16th.
▲ Alleviate the burden of medical expenses and expand support for the health-disadvantaged
Chairman Jeong first stated, “We will support the provision of appropriate compensation in essential medical fields.” The policy is to improve accessibility by quickly applying health insurance benefits to essential medical supplies. In order to manage non-covered services, we plan to operate the non-covered service reporting system expanded to all medical institutions without a hitch, establish a standard classification system, and promote the disclosure of non-covered service information.
Customized support for the health-disadvantaged will also be strengthened. In order to alleviate excessive medical expenses and the burden of nursing expenses, support for medical expenses such as catastrophic medical expenses and the upper limit of out-of-pocket expenses will be strengthened. The nursing hospital nursing support pilot project will also proceed without a hitch, and the nursing care integrated service will be operated substantively. The 3rd stage of the sick pay pilot project will be stably operated, and nursing care expenses for essential medical devices for home treatment will also be expanded. Chairman Jeong said, “We will strengthen customized support, including expanding support for pregnancy and childbirth.”
▲Reasonable improvement of qualification, imposition, and collection systems
The qualification assessment collection system will be rationally improved. In order to improve the fairness of insurance premium burden, income-based assessment will continue to be promoted and qualification management will be thoroughly implemented. In order to increase public convenience and efficiently collect overdue insurance premiums, the notice collection work will be advanced, such as the expansion of mobile-centered electronic notice services. Online digital civil service services will also be expanded.
The National Health Insurance Service plans to pursue collection by type of delinquency for businesses and habitual high-amount delinquents. The National Health Insurance Service explains that it will protect the right to receive medical care by postponing delinquent collection measures for livelihood-related delinquents.
▲Establishing a personalized health management system for each life cycle
The National Health Insurance Corporation plans to review the adjustment of examination items based on medical and scientific validity in order to establish an evidence-based health examination system. It plans to expand examinations by life cycle through a student health examination pilot project and actively support the government’s national mental investment support project. It will also strengthen the chronic disease management system, such as the primary care chronic disease pilot project. It plans to support rational medical use by managing excessive medical use and multiple drugs, such as differentiating out-of-pocket expenses.
It provides customized health services to the public by utilizing big data. Chairman Jeong said, “We will activate personalized use by improving Health iN,” and “We will support government and industry research by producing scientific evidence for major policies and providing biographical information to the biohealth industry.” Chairman Jeong added, “To this end, we will strengthen infrastructure by building a stable database, expanding analysis centers, and improving information systems.”
▲ Strengthening demand-oriented medical, nursing, and care services
We will strengthen demand-oriented medical care services. In preparation for the super-aging society, we plan to diversify home care services such as integrated home care services and home medical centers. We also plan to carry out the integrated assessment system and pilot projects for integrated support for elderly medical care without a hitch. In order to improve the quality of long-term care facility services, we will prepare a designation renewal manual and promote customized consulting for new institutions and institutions with lower evaluation levels. In addition, we plan to strengthen the professionalism and human rights of care workers by making continuing education mandatory.
▲Building sustainable insurance finances
The policy is to build sustainable insurance finance. Chairman Jeong said, “In order to strengthen the foundation for financial management, we will implement the ‘mid-term financial soundness’ plan linked to government policies without a hitch,” and “We will proactively manage risk factors by upgrading the financial analysis system.” In order to efficiently spend finances, the Health Insurance Corporation plans to strengthen monitoring of expenditure items and analysis of benefits, and also activate the Financial Guardian Proposal and Report Center. The policy is to secure stable government support and upgrading fund management.
We will also strengthen the management of illegal establishments and fraudulent receipts. In order to strengthen the management of illegal establishments, we plan to block their entry from the stage of establishment permits. We plan to introduce special investigators for the corporation and establish grounds for entrusting administrative investigation authority. We will also stably establish a system for verifying the identity of nursing institutions to prevent fraudulent receipts in advance. Chairman Jeong stated that we will expand the number of nursing institutions that are subject to on-site verification and actively respond to unfair claims and insurance fraud by cooperating with related organizations.
▲Support for stable system operation through efficient organizational management
Chairman Jeong said, “We plan to pursue company-wide management innovation. We will strengthen internal control and enhance public trust by practicing ethical management in our daily lives.” He added, “We will lead eco-friendly carbon neutrality by discovering representative social contribution projects, while creating a safe work environment and strengthening ESG management.” Chairman Jeong added, “We also plan to expand international cooperation for the global expansion of health insurance and long-term care insurance.”
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