South Korea to Boost Regional, Essential Healthcare Fees with $3.6 Billion Fund Injection

South Korea's government plans a significant overhaul of its healthcare reimbursement system, boosting payments for regional and essential medical services by an annual 3.6 trillion won. This initiative, approved by the Health Insurance Policy Review Committee, aims to rectify imbalances in healthcare access and compensation, with implementation set to begin in December.

The reform introduces preferential fee schedules for medical institutions in non-metropolitan areas and six underserved regions within the Seoul metropolitan area. These areas will receive a 10% surcharge on all surgeries and treatments, with an additional 10% for nighttime, holiday, or emergency procedures. Clinics in 84 designated low-population areas will see a 5% increase in consultation and inpatient fees.

Crucially, compensation for critical and emergency care will be substantially enhanced. Hospitals providing advanced treatments will see a 20% increase in surgical and procedural fees. Emergency inpatient surgeries at regional emergency centers, particularly those involving critical patients admitted via an emergency room, could receive up to 5.5 times the base fee, up from the current 4.5 times.

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The fee for regional preferential treatment, childbirth, and inpatient care for children under two will have no patient co-payment, and for critically ill patients, the co-payment will remain at 0-10% due to the existing special calculation system.

To fund these increases, the government will reduce fees for certain diagnostic tests, including blood work and advanced imaging like MRI and CT scans, which are deemed to be overcompensated. These reductions are expected to generate 2.6 trillion won, with the remaining 1 trillion won to be drawn from the health insurance reserve. The government anticipates that while patient co-payments for some services might slightly increase, the overall out-of-pocket expenses will remain stable due to the fee reductions in diagnostic tests.

Health Minister Chung Ho-young stated that this fee adjustment is part of a broader strategy that includes expanding regional medical workforce, mitigating medical malpractice burdens, and strengthening national university hospitals. The goal is to ensure more equitable access to quality healthcare across the country.

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Along with the health insurance fee reform, we will additionally implement institutional improvements such as expanding regional medical workforce, easing civil and criminal burdens from medical accidents, and fostering national university hospitals.