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Korea (Republic of) - P4H Network
Current Health Expenditure (CHE) as % Gross Domestic Product (GDP)8.4%CHE/GDP
Out-of-pocket (OOPS) spending as % of Current Health Expenditure (CHE)26.7%OOP/CHE
Domestic General Government Health Expenditure (GGHE-D) as % General Government Expenditure (GGE)13.6%GGHE-D/GGE
Gross Domestic Product (GDP), in constant (2020) US$ in millions (M), billions (B), or trillions (T)1.7TGDP (USD)
Population in thousands (K), millions (M) or billions (B)51.8MPopulation

Timeline of Korean Health Financing Reforms

Telemedicine was temporarily permitted in response to the COVID-19 pandemic

A two-year pilot programme for community care (for aging in place) began in 16 districts

The First Comprehensive Plan of NHI (2019– 2023) was established

Dementia patients at an early stage became eligible for LTC insurance

Extra charge for treatments by highly experienced specialists was banned

Compulsory enrolment in health insurance for all foreigners and immigrants staying in the Republic Korea for more than 6 months

A five-year benefit expansion policy, called Moon Jae-In care or Moon Care, was announced

NBLSS reforms expanded population coverage and personalized the benefits in four categories

The levels of eligibility of LTCIs were expanded from three to four levels

Economic evaluation exemption for anticancer and orphan drugs

The copayment ceiling was further expanded from three to seven income levels

A pilot programme for RSA was launched for orphan drugs and pharmaceuticals against cancer and rare diseases

The DRG-based payment system for seven DRG was mandatorily implemented at general and tertiary hospitals

A five-year benefit expansion policy (2014– 2018), the Benefit Expansion Policy for Four Major Severe Diseases, was announced

The homeless became a Type 1 beneficiary of MA

The DRG-based payment system for seven DRG was mandatorily implemented at clinics and hospitals

Dementia Management Act was enacted

Pay-for-performance scheme on a few services was implemented based on quality assessments

Copayment reductions from 10% to 5% were applied for cancer and cardiovascular diseases

The Price-Volume Agreement was implemented

A new DRG-based payment, a combination of prospective payment and fee-for-service, was implemented as a pilot programme

The cost of hospitalization for Type 2 MA beneficiaries was reduced from 15% to 10%

Copayment reductions from 20% to 10% were applied for rare and incurable diseases

A five-year benefit expansion policy (2009– 2013) was announced

Conversion factor for fee scheduling was subdivided by the medical institution

Economic evaluation was required for listed drugs

Fixed rate per diem payment system for LTC hospitals was introduced

LTCI was introduced, separate from the NHI, but managed by the NHIC

LTCI Act was enacted

The user fee for outpatient care was applied to MA beneficiaries: KRW 1000 for primary care and KRW 2000 for tertiary hospitals

The positive list system was introduced

Copayment reductions from 20% to 10% were applied for cancer and cardiovascular diseases

A four-year benefit expansion policy (2005– 2008) was announced

A copayment ceiling was introduced for cumulative OOP payments over six months

The National Basic Living Security Act, enacted from Livelihood Protection Act

Financial accounts of the NHI schemes were consolidated

A HIPDC was introduced to decide the coverage of benefits package

The NBLSS was launched

The fee scheduling method changed to be based on a RBRV system

Medicine prescribing and dispensing were separated between doctors and pharmacists

All health insurance funds were merged into a single national health insurer (NHIS)

Fee schedule began to be negotiated between the insurer and provider associations

National Health Insurance Act enacted to succeed National Medical Insurance Act (enforced on 1 January 2000)

The Fiscal Stabilization Fund was established to reallocate contribution revenues across insurance funds

National Medical Insurance Act enacted succeeding Medical Insurance Act

A DRG-based payment was launched as a pilot programme based on voluntary participation

Long-term care hospitals were introduced for rehabilitation, mental health and postacute care

The programme covered all self-employed in urban areas, and mandatory health insurance achieved the universal coverage of population

Pharmaceuticals were covered by the NHI benefit package

The pilot programme covered all selfemployed in rural areas

Employees in companies with more than 16 workers were enrolled in NHI

The pilot programme for the self-employed was implemented in five rural and one urban areas

Welfare of Senior Citizens Act was enacted

A pilot programme for the self-employed was implemented in three rural areas

Employees in companies with more than 100 workers were enrolled in NHI

Government employees, teachers and employees of companies with more than 300 workers were enrolled in NHI

An MA programme for people living in poverty was initiated

Employees of large companies with more than 500 workers were enrolled in NHI

Medical Insurance Act was revised for compulsory enrolment as a legal foundation for SHP and UHC

Medical Insurance Act was enacted for voluntary enrolment

Livelihood Protection Act was enacted

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Reform areas
 
 
 
 
 
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