Introduction
The NHIA, cooperating with the internationally renowned academic publisher Springer Nature, has published the English-language book Digital Health Care in Taiwan- Innovations of National Health Insurance in open access. The electronic version of the book has been published on August 15th, 2022.
- It is the only book that introduces Taiwan's National Health Insurance system and its history, current status, future reforms and successful experience.
- Spotlights the NHI's application of digital technology to improve health care.
- Serves as an important reference for the implementation of health insurance systems in other countries around the world.
Chapter 1 Introduction to the National Health Insurance of Taiwan
This chapter introduces the core concept and underlying spirit of Taiwan's NHI, as well as the background, purpose, and history of the NHIA. Also, readers may learn the operations of Taiwan’s NHI system, its current state, challenges it faces, and policies in the future.
Chapter 2 Income Strategy
A stable and sufficient financial resource for National Health Insurance is the foundation. Therefore, this chapter details the NHI revenues and expenditures, types of financial sources, designs and calculations of premiums and co-payments, and the ways to achieve fairness.
Chapter 3 Payment Structure
This chapter discusses the NHI payment systems, including the global budget payment system and the diverse payment systems.
Chapter 4 Comprehensive Policies
This chapter provides policy examples, such as the Separation of Medicine and Pharmacy, Patient-Centered Integrated Care Plans, Connection to Long-Term Care After Hospital Discharge, Tiered Medical Care System, Co-Payment Adjustment, explaining the policy role of the NHIA, and which programs or measures were used to achieve policy goals.
Chapter 5 Pursuing Health Equity
This chapter explains how the NHIA realizes equal medical rights for the entire population through policy promotion and system design. This includes, especially, policies aimed at disadvantaged groups, people living in remote villages and outlying islands, and patients with rare diseases.
Chapter 6 Infrastructure of the Medical Information System
This chapter introduces the NHI medical information system and NHI MediCloud System, and explains the data protection mechanisms the NHIA uses.
Chapter 7 Innovative Applications of the Medical Information
This chapter introduces the experience and achievements of the NHIA during the COVID-19 pandemic, including telemedicine, the Virtual NHI Card, NHI MediCloud, and TOCC marks.
Chapter 8 Drug and Medical Device Reimbursement
This chapter introduces the NHI pricing policies for pharmaceuticals and medical devices and explains the correlations between pharmaceuticals pricing, medical devices pricing and the NHI system. This chapter also covers how the NHIA uses digital tools and data for decision-making.
Chapter 9 Coverage of Advanced Treatments and Medical Devices
As science and technology continue to progress, the NHI is also facing the challenge for including advanced therapies and innovative medical devices. This chapter introduces the NHIA's considerations and its decision-making processes for covering advanced therapies (such as immuno-oncology therapies), next generation sequencing (NGS), and innovative medical devices.
Chapter 10 High-Value Medical Information and Quality Claims Review
This chapter introduces the achievements of the NHIA in promoting high-quality medical data. It also explains how the NHIA implemented an efficient review system to avoid inappropriate medical expenses and ensure healthcare quality.
Chapter 11 Applications of Big Data and Artificial Intelligence
Then NHIA has accumulated over 20 years of NHI data. This chapter describes how this big data has helped the NHI operations.
Chapter 12 Digital Transformation of Big Data
This chapter discusses potential social benefits brought by big data applications of the NHI database. It also emphasizes that the NHIA will continue its efforts towards a balance of personal information autonomy with public interest.