Under the National Health Insurance Act: Tw-DRG Payment System
The DRGs (Diagnosis Related Groups) system is an insurance payment method. The first phase of Taiwan DRGs (Tw-DRGs) was implemented on January 1, 2010 with 164 groups, followed by the second phase on July 1, 2014 with an additional 237 groups (total: 401 groups). The third phase had been scheduled to add 1262 more DRGs on March 1, 2016, aside from 53 groups postponed (including the group of premature babies), making an expansion to 1,716 groups. However, newly elected members of the Legislative Yuan among different political parties teamed up to stop it. This showed obviously that the NHIA and its contracted medical care institutions haven’t reached a consensus. What exactly are the rules of this payment system under National Health Insurance Act? Are they reasonable? No matter how the law sets all the rules, we should still keep in mind that the ultimate goal of medical care is to treat the patient, not the disease.