Health Insurance Payment System to Change: Rewards Based on Quality and Outcomes Rather Than Volume of Care
Published
A recommendation has been made that the way health insurance costs are paid should be changed. The Innovation Committee proposed reforming the current system, in which hospitals receive more money the more treatments they provide, into a system that rewards them based on the quality and outcomes of care.
This recommendation is set against the backdrop of health insurance finances growing rapidly. According to materials from the Innovation Committee, the combined annual budget required for the 49 projects pursued by the government was 52.8 billion won in 2016. However, in 2025 it rose to 3,373.4 billion won. Within about nine years, it has increased nearly 64 times. As the financial burden grows, discussions on how to manage spending continue.
It is expected that if hospitals are rewarded based on outcomes rather than the volume of care, they will reduce unnecessary tests and treatments and pay more attention to patients' recovery. For patients, how effective a treatment actually was will become more important. However, further detailed review is needed on what standards will be used to measure outcomes and how it will affect small and large hospitals respectively.
The government and related agencies plan to prepare detailed measures based on the Innovation Committee's recommendation. If the system changes, the way medical institutions operate and the treatment process patients receive may also change. The public needs to check the specific plans and implementation schedule that will be announced in the future.
Sources: 코리아헬스로그
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