The government will increase the reimbursement rates for complex surgeries, such as head and neck cancer surgery, by up to 80%. It has also decided to create a new reimbursement rate for intensive care unit admissions for those whose mental health symptoms have suddenly worsened and require urgent treatment.
On the 24th, the Ministry of Health and Welfare held the 13th Health Insurance Policy Review Committee meeting and announced the approval of increases in reimbursement rates for complex head and neck surgeries, the establishment of new rates for initial treatment of acute mental health patients, and new rates for medical hospices in traditional medicine hospitals.
Head and neck cancer refers to cancers that occur in the head and neck regions, excluding the eyes and brain, including areas such as the mouth, nose, pharynx, larynx, tongue, salivary glands, and thyroid gland.
Surgery for head and neck cancer is considered challenging due to its complexity and the difficult recovery process, yet it has been identified as an undesirable field due to insufficient compensation for medical professionals. In fact, this year, among seven regional emergency medical centers in Seoul, the only institution that had applicants for head and neck fellowships was Seoul National University Hospital.
Reflecting this reality, the government has decided to increase the reimbursement rates for 24 head and neck cancer-related surgeries, such as oral tumor excision, laryngeal and hypopharyngeal excision, and tongue cancer surgery, by 20% to 80%. For cases where surgery is needed in adjacent areas, the payment standards will be improved to reflect manpower and time required, and the reimbursement rates for five high-severity surgeries, including airway obstruction, will be increased by 15% to 55%. Additionally, a new reimbursement item will be added for 'free flap surgery using perforator flaps' used to reconstruct areas after surgery.
Acute mental health patients are those whose mental health symptoms, such as schizophrenia, bipolar disorder, and depression, have suddenly worsened, requiring urgent treatment. The Ministry of Welfare plans to designate 'acute mental health intensive care hospitals' in the second half of the year and has established that if patients are admitted to the intensive care unit of these hospitals, a separate 'inpatient fee' will be calculated for up to 30 days. An additional fee will apply for the first 14 days of hospitalization.
In addition, the reimbursement for 'psychiatric emergency interventions' provided to patients admitted to the intensive care unit will be increased by 100%, and the number of sessions for individual psychotherapy, family therapy, and occupational and recreational therapy will also be increased. The government plans to induce proactive use of medical resources for patients in the early stages of illness.
To reduce misunderstandings, 'isolation protection fees,' which were one of the psychiatric reimbursement items, will be renamed 'psychiatric stabilization room management fees.' This applies when patients are isolated in a separate space for stable observation and management, regardless of restraint or coercive measures.
In tandem, traditional medicine hospitals that operate medical services will be designated as inpatient hospice specialized institutions, and separate reimbursement rates will be established for inpatient hospice care in these institutions.
Reimbursement for mobility aids for severely disabled children will also be expanded. Mobility support walkers, strollers for the disabled, and children's electric wheelchairs will be newly included as reimbursement items, leading to an expected reduction in out-of-pocket expenses of up to 1.8 million to 3.42 million won.
On this day, the progress of the medical delivery system improvement project was also reviewed. According to the Ministry of Welfare, compared to September last year before the structural transition of the advanced general hospitals, the number of complex surgeries increased from 27,534 to 40,293 as of March this year, with inpatient cases rising by 13% and outpatient cases by 5%. The number of referrals and returns has also increased by 2.5 to 3 times, indicating strengthened cooperation in medical treatment.
A pilot project to shorten the working hours of residents is also being conducted. A ministry official noted, 'Currently, each hospital has a team of specialists and medical support nurses handling the treatment,' and added, 'The Ministry will maintain a specialist-centered treatment system even after the return of residents and continue to promote improvements in the training environment and the advancement of educational programs.'