Since the National Health Insurance was started in 1995, in light of the fact that it is inconvenient for residents in certain mountainous areas and offshore islands to seek medical attention due to their unique geographical environments, to take care of those who are covered by NHI but have no access to medical care, Mennonite Christian Hospital was the authorized to begin the demonstrative plan by sending their physicians in March 1997 to be based at the Public Health Center in Xiulin Township of Hualien County and became the pioneer among large hospitals in supporting medical care in mountainous areas and on offshore islands. The NHI IDS (Integrated Delivery System) plan was officially announced in November 1999 and was meant to encourage collaboration between large hospitals and local public health centers. Their integration will help provide residents in the mountainous areas and on offshore islands with the needed medical services and develop localized medical services in honor of the idea about “health equality”; it lays a complete cornerstone for medical care in domestic outlying areas.

There are a total of 7 medical centers, 14 regional hospitals, and 5 district hospitals available at the moment to provide 50 mountainous and offshore island areas throughout Taiwan and nearly 460 thousand-plus beneficiaries with fundamental medical care through clinics at fixed locations, 24-hour emergency medicine and transferal service, nighttime clinics, and specialized consultations (internal medicine, orthopedics, dentistry, gynecology, ophthalmology, and family medicine, etc.), circuit medical care, home care, preventive care, disease screening, health education and promotion, disease and health management, among other services. The National Health Insurance Administration indicates that it invests additional budget of around NT$600 million each year as incentives; each month, provided more than 1,900 specialized outpatient visits. Generally speaking, the IDS program has effectively improved medical accessibility, appropriate primary care and enhanced care for patients with chronic disease in mountain areas and offshore islands.

Nearly 20 years have passed since the initial introduction of the IDS plan. In light of its positive effects on the medical care and health of residents in mountainous areas and on offshore islands, the National Health Insurance Administration held a seminar on October 16, 2017 and invited experts and scholars to share their visions for the next phase of the IDS plan.