Timeline of Korean Health Financing Reforms
Reform areas
2020
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Telemedicine was temporarily permitted in response to the COVID-19 pandemic
2019
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A two-year pilot programme for community care (for aging in place) began in 16 districts
2019
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The First Comprehensive Plan of NHI (2019– 2023) was established
2018
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Dementia patients at an early stage became eligible for LTC insurance
2018
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Extra charge for treatments by highly experienced specialists was banned
2018
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Compulsory enrolment in health insurance for all foreigners and immigrants staying in the Republic Korea for more than 6 months
2017
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A five-year benefit expansion policy, called Moon Jae-In care or Moon Care, was announced
2015
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NBLSS reforms expanded population coverage and personalized the benefits in four categories
2014
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The levels of eligibility of LTCIs were expanded from three to four levels
2014
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Economic evaluation exemption for anticancer and orphan drugs
2014
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The copayment ceiling was further expanded from three to seven income levels
2013
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A pilot programme for RSA was launched for orphan drugs and pharmaceuticals against cancer and rare diseases
2013
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The DRG-based payment system for seven DRG was mandatorily implemented at general and tertiary hospitals
2013
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A five-year benefit expansion policy (2014– 2018), the Benefit Expansion Policy for Four Major Severe Diseases, was announced
2012
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The homeless became a Type 1 beneficiary of MA
2012
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The DRG-based payment system for seven DRG was mandatorily implemented at clinics and hospitals
2011
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Dementia Management Act was enacted
2011
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Pay-for-performance scheme on a few services was implemented based on quality assessments
2010
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Copayment reductions from 10% to 5% were applied for cancer and cardiovascular diseases
2009
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The Price-Volume Agreement was implemented
2009
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A new DRG-based payment, a combination of prospective payment and fee-for-service, was implemented as a pilot programme
2009
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The cost of hospitalization for Type 2 MA beneficiaries was reduced from 15% to 10%
2009
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Copayment reductions from 20% to 10% were applied for rare and incurable diseases
2009
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A five-year benefit expansion policy (2009– 2013) was announced
2008
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Conversion factor for fee scheduling was subdivided by the medical institution
2008
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Economic evaluation was required for listed drugs
2008
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Fixed rate per diem payment system for LTC hospitals was introduced
2008
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LTCI was introduced, separate from the NHI, but managed by the NHIC
2007
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LTCI Act was enacted
2007
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The user fee for outpatient care was applied to MA beneficiaries: KRW 1000 for primary care and KRW 2000 for tertiary hospitals
2006
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The positive list system was introduced
2006
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Copayment reductions from 20% to 10% were applied for cancer and cardiovascular diseases
2005
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A four-year benefit expansion policy (2005– 2008) was announced
2004
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A copayment ceiling was introduced for cumulative OOP payments over six months
2004
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The National Basic Living Security Act, enacted from Livelihood Protection Act
2003
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Financial accounts of the NHI schemes were consolidated
2002
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A HIPDC was introduced to decide the coverage of benefits package
2000
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The NBLSS was launched
2000
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The fee scheduling method changed to be based on a RBRV system
2000
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Medicine prescribing and dispensing were separated between doctors and pharmacists
2000
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All health insurance funds were merged into a single national health insurer (NHIS)
1999
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Fee schedule began to be negotiated between the insurer and provider associations
1999
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National Health Insurance Act enacted to succeed National Medical Insurance Act (enforced on 1 January 2000)
1998
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The Fiscal Stabilization Fund was established to reallocate contribution revenues across insurance funds
1998
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National Medical Insurance Act enacted succeeding Medical Insurance Act
1997
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A DRG-based payment was launched as a pilot programme based on voluntary participation
1994
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Long-term care hospitals were introduced for rehabilitation, mental health and postacute care
1989
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The programme covered all self-employed in urban areas, and mandatory health insurance achieved the universal coverage of population
1989
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Pharmaceuticals were covered by the NHI benefit package
1988
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The pilot programme covered all selfemployed in rural areas
1983
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Employees in companies with more than 16 workers were enrolled in NHI
1982
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The pilot programme for the self-employed was implemented in five rural and one urban areas
1981
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Welfare of Senior Citizens Act was enacted
1981
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A pilot programme for the self-employed was implemented in three rural areas
1981
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Employees in companies with more than 100 workers were enrolled in NHI
1979
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Government employees, teachers and employees of companies with more than 300 workers were enrolled in NHI
1977
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An MA programme for people living in poverty was initiated
1977
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Employees of large companies with more than 500 workers were enrolled in NHI
1976
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Medical Insurance Act was revised for compulsory enrolment as a legal foundation for SHP and UHC
1963
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Medical Insurance Act was enacted for voluntary enrolment
1961
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