The challenges related to a new medical insurance policy for ultrasounds and their solutions

In the Republic of Korea, medical insurance coverage for ultrasounds began on October 1, 2013 for four major categories of illness: cancer, heart disease, cerebrovascular disorders, and rare and incurable diseases. However, several problems associated with this ultrasound insurance coverage have arisen: broad classification of ultrasound examination procedures, small and distorted insurance fees, and inappropriate insurance fee calculation methods. In order to prevent the deterioration of medical quality as well as confusion in the medical field, it is necessary that the Ministry of Health and Welfare, the Korean Medical Association, and other ultrasound-related academic societies cooperate to subdivide the classification of ultrasound examination procedures, modify the insurance fee, and properly calculate the ultrasound insurance fee.

After designation of Research-driven Hospitals

In April 2013, the Korean Ministry of Health and Welfare designated 10 hospitals as "Research-driven Hospitals" for 3 years, which meant that these hospitals met the predefined government standards for research in terms of organization governance, human resources, equipment, etc. The project on Research-driven Hospitals comprises two programs: one is the Evaluation and Designation Program, and the other is the Systems and R&D Budget Support Program. The latter is composed of two tasks: making and improving the support systems, such as a tax system, to foster research in the designated Research-driven Hospitals; and allocating the R&D Budget to only the winners of the competition among the designated hospitals according to the National Health Technology Plan. The R&D funding will be about 1.2 trillion KW ($1 billion US), and half of this funding will be allocated during the first 9 years. The former program is to formulate the standards and rules for Research-driven Hospitals and to evaluate and designate a qualified hospital as a research-driven hospital. Although there have been many concerns regarding the project, we are hoping that this project will go well and achieve great success, making the Research-driven Hospitals in Korea among the world's best. In fact, we hope that the Research-driven Hospitals will not only foster research that will bridge the current gap between basic and clinical research but also improve the current health care environment and develop the health technology industry, and finally help people lead healthier lives as well as help patients and their families recover faster from disease.

1 Years after beginning of DRG services system

Today's diagnosis related group (DRG) services system has improved medical insurance fees and subdivisions of disease compared with the past DRG system, but does not appropriately take into account the development of complications of severe disease and does not properly compensate care providers for the costs of using the newest medical devices. The Korean DRG system model needs to reflect the medical environment and the latest developments. Therefore, Cooperation with the government, medical service personnel, and citizens is necessary for the improvement of the DRG services system.