Digital Health Care in Taiwan : : Innovations of National Health Insurance.

• Author: Lee, Po-Chang.
• TeilnehmendeR: Wang, Joyce Tsung-Hsi.; Chen, Tzu-Yu.; Peng, Chia-hui.
• Place / Publishing House: Cham : : Springer International Publishing AG,, 2022.; ©2022.
• Year of Publication: 2022
• Edition: 1st ed.
• Language: English
• Physical Description: 1 online resource (286 pages)

Table of Contents

Intro -- Foreword -- Investing in the National Health Insurance Is Investing in Health -- Preface -- Thoughts on Reforming the National Health Insurance -- Acknowledgments -- Contents -- About the Contributors -- About the Editors -- Abbreviations -- Chapter 1: Introduction to the National Health Insurance of Taiwan -- The Core Concepts of Taiwan's National Health Insurance -- The Organisational Structure and History of the National Health Insurance Administration -- Characteristics of Taiwan's National Health Insurance -- The Finance of the National Health Insurance in Taiwan -- Medical Utilisation of the National Health Insurance -- The Payment System of the National Health Insurance -- The Healthcare Quality of the National Health Insurance -- The Information System of the National Health Insurance -- Achievement of the National Health Insurance -- The Critical Blueprints of Taiwan's National Health Insurance -- Chapter 2: Income Strategy -- Introduction -- Sources of National Health Insurance Income -- Premium Income -- Proportions of Various Sources of Income -- Enrolment Eligibility and Premium Calculations -- Classification of the Insured -- Calculation of Premiums -- Calculation of the Premium Rate -- The Annual Premium Rate Review Process -- The Financial Structure of National Health Insurance -- Establishment of an Actuarial Model to Calculate the Premium Rate -- Co-payments Under the National Health Insurance Act and How They Are Charged -- Co-payments for Outpatient Visits -- Co-payments for Emergency Care -- Co-payment Rates for Inpatient Care -- Fair Burden─Change Unnecessary Health Care [1] -- The Value of National Health Insurance Manifests When Major Illnesses Occur -- Provide the Best Drugs for Patients in Need -- Avoid the Vicious Circle -- Drug Co-payments May Increase Slightly -- Conclusion -- Reference.

Chapter 3: Payment Structure -- Introduction -- Different Payment Methods in the National Health Insurance System -- A Simple Explanation of the Global Budget Payment System -- Introduction to Each Payment Method -- Implementation of Pay-for-Performance and Bundled Payment in Recent Years -- Global Budget Payment System -- Planning the Annual Global Budget -- Global Budget Distribution and Management -- Reducing the Provision of Unnecessary and Excessive Medical Services to Increase the Value of the Relative Value Unit -- Relative Value Units and Relative Value Unit Values are the Overall Causes and Outcomes of Each Other -- Adjusting Relative Value Units to Promote Balanced Development of Medical Specialties -- Guaranteeing the Relative Value Unit Value to Encourage Investment in the Healthcare Workforce -- Establishment and Revision of Fee Schedule -- Fee Schedule Revision Procedure -- Health Technology Assessment -- Items Not Been Covered by the NHI -- Self-Management Plan Under the Global Budget Payment System and Corresponding Measures of Insufficient Budgeting -- Self-Management Plan -- Subtracting Relative Value Units Directly -- Sharing the Relative Value Unit Gap -- Analysis and Reflections -- Chapter 4: Comprehensive Policies -- Introduction -- Implementation of the Separation of Medicine and Pharmacy from a National Health Insurance Perspective -- The Meaning of Separating Medicine and Pharmacy -- The Effectiveness of Separating Medicine and Pharmacy -- Ownership of Dispensing Rights from a Legal Perspective -- The Person in Charge of Medical Services in the National Health Insurance System -- The Strategy to Promote Separation of Medicine and Pharmacy-Discussion and Conclusions -- Patient-Centered Integrated Care Plans -- National Health Insurance Big Data Reflect the Ageing Population -- The Family Doctor Integrated Care Program.

Providing a New Model of Integration and Interdisciplinary Services -- Incorporating the Labor Power of Home Care into Integrated Care -- Promoting the Vertical Integration of Hospitals and Clinics -- Healthcare Digital Transformation Brings Win-Win-Win for Physicians, Patients, and National Health Insurance -- Connection to Long-Term Care After Hospital Discharge -- Covering the Discharge Planning and Follow-Up Management Fee Through National Health Insurance -- Implementation of Long-Term Care 2.0 -- Connection Between National Health Insurance Discharge Planning and Long-Term Care 2.0 -- Tiered Medical Care System -- Current Distribution of Hospital Levels -- Encouraging Big Hospitals to Treat Acute, Severe, and Difficult Diseases -- Small Hospitals Are the Leaders of Community Medical Care -- Consolidate Small Hospitals in Remote Areas to Continuously Protect the Health of Residents -- Co-Payment Adjustment -- Current Situation Analysis -- The Planning, Thinking, and Direction of Outpatient Co-Payments -- Conclusion -- References -- Chapter 5: Pursuing Health Equity -- Introduction -- Removing Barriers to Health Care to Protect the Disadvantaged -- Decoupling of the Payment of Premiums from the Right to Receive Medical Care -- The National Health Insurance Premium Deferment Paying Measures of the COVID-19 Epidemic -- Medical Services on Remote and Offshore Islands -- The Integrated Delivery System -- Improvement Plan for Medically Underserved Areas -- Upgrading Medical Services in Underserved Areas -- National Health Insurance Strives to Remove Barriers to Medical Treatment -- Prospects -- National Health Insurance Stands by Patients with Rare Diseases -- Rare Diseases Are Categorized as Catastrophic Illnesses to Waive Patient Co-Payments -- Strengthening Control Measures for Orphan Drugs -- My Health Bank-Promoting Self-Health Management.

My Health Bank Guards Our Health -- Rapid Cell Phone-Based Certification Allows Users to Manage Their Medical Information Easily -- Family Member Management Function Added to Safeguard Family Health -- Software Development Kit Connects Health Services Better -- Supporting Name-Based Mask Distribution System to Assist the Country in Epidemic Prevention -- The Significance of Including National Health Insurance in Elementary School Teaching Materials -- Chapter 6: Infrastructure of the Medical Information System -- Introduction -- Cornerstone of the National Health Insurance Database-Introduction to the NHI Medical Information System -- Highly Automated Process of Medical Claims -- Establishing National Health Insurance MediCloud System to Implement a Tiered Medical Care System -- The National Health Insurance MediCloud System -- Building Patient-Centered "NHI PharmaCloud System" -- Upgrading of the "NHI MediCloud System" -- Design of Active Reminders in the NHI MediCloud System -- Personal Privacy Protection and Information Security Management -- Cloud-Based Healthcare Technology Is a Future Trend -- Continuously Upgrading the NHI MediCloud System -- Applying the Technology to Provide Reminders Proactively -- Image Upload, Retrieval, and Sharing -- Importing ISO Certification to Protect Personal Information -- Integrating Information Across Organizations to Safeguard the Health of All Residents -- Continuous NHI MediCloud System Upgrade Enables Smart Medical Care -- The National Health Insurance Information Security Management System and Data Protection Mechanism -- Continuous Improvement of the Information Security Management Mechanism -- Defense-in-Depth Mechanism Implementation and Internal and External Network Isolation Policies -- Regular Information Security Testing and Drills to Reduce the Potential Risks of Information Security.

Implement Database ID Entity Encryption Mechanism -- Conclusion -- Chapter 7: Innovative Applications of the Medical Information -- Introduction -- The Important Milestone: "2021-First Year of Telemedicine Being Covered" -- The COVID-19 Pandemic Accelerates the Inclusion of Telemedicine into the Benefits Package of the National Health Insurance -- Inclusion of Telemedicine in the Fee Schedule in 2021 -- Digital Technology Extends Medical Care -- The Major Stride of Health Insurance Information Network and Far-Reaching Medical Services Made Possible by 5G -- Brief Talk About the Health Insurance Information Network -- Enter the 5G Era -- Future Direction -- Virtual NHI Card Users in the 5G Era -- Planning for a New Generation NHI Card -- The Virtual NHI Card Pilot Program -- Continuous Function Progresses -- Using the National Health Insurance Information System for COVID-19 Prevention -- The Cross-Departmental Cooperation of the National Health Insurance Cloud System to Add a TOCC Reminder -- Establish a Control System for Masks and Distribute Protective Materials Fairly -- Enhance NHI Express APP and My Health Bank Functions for COVID-19 Prevention [1] -- The Name-Based Medical Mask Distribution System Is a Successful Model Established by Government and Private Sector Partnerships to Fight the COVID-19 Pandemic [2] -- Medical Masks Become Popular Anti-epidemic Materials -- Government and Private Sectors Cooperate to Create the Mask Map -- The Coverage Rate of Name-Based Medical Mask Distribution System Is Improving Continuously -- The Resilience of the NHIA Organization Is a Blessing For All -- References -- Chapter 8: Drug and Medical Device Reimbursement -- Introduction -- How Are Drug Prices Determined? -- Classification and Pricing of the Drugs Under the National Health Insurance -- Adjustment of Drug Price.

How to Classify Medical Devices and Determine the Price?.