Government to increase doctor’s fee by 4 percent to improve quality of consultation

Second Vice Minister of Health and Welfare Park Min-soo speaks at the 15th Health Insurance Policy Review Committee on July 24. Reporter Cho Tae-hyung

The government has decided to raise doctor’s fees by 4 percent next year as a way to improve the “three-minute consultation,” which has been pointed out as a problem. This is to improve the compensation structure by further compensating undervalued medical practices, breaking away from the method of raising fees at the same rate for all medical practices.

On July 24, the Ministry of Health and Welfare held the 15th Health Insurance Policy Review Committee to deliberate and decide on the “Hospital and Clinic Conversion Index Determination for 2025.” At last month's review committee, the medical care benefits to be applied to medical sites next year was decided, but the benefits for hospitals and clinics were discussed this month without being decided due to a large difference in position between representative organizations, which are the Korea Hospital Association (KHA) and the Korean Medical Association (KMA), and other members.

In this review committee, the increase was determined by weighting essential medical services that are relatively undervalued. The overall rate of increase was significantly lower than the 1.9 percent and 1.6 percent rate of increase for hospitals and clinics, respectively, proposed by the National Health Insurance Service’s financial management committee prior to the review committee.

Instead of raising the overall medical care benefits by only 0.5 percent (4.1 won), the doctor's fee of clinics will be raised significantly by applying a higher-than-average increase of 4 percent to consultation fees (for first visit and re-visit). Instead of raising the overall medical care benefits by only 1.2 percent, the additional rate for surgeries and treatments performed on holidays will be increased at hospitals.

The additional rate for surgeries, treatments, and anesthesia performed at hospitals at nights and on holidays will be increased from 50 percent to 100 percent, and the rate for emergency medical procedures performed in emergency rooms will be increased from 50 percent to 150 percent.

The decision was made in response to the growing criticism that in the decision-making structure, which has uniformly raised the medical care benefits for all medical practices, the imbalance in which certain medical practices are not properly compensated is growing. The medical care benefits refer to the price for medical treatment.

The benefit is determined by multiplying the “relative value score,” which is a score of the relative value of about 6,000 medical procedures, and the “conversion index,” which is the unit price per score. If the conversion index goes up, the unit price goes up, so the final benefits also go up.

However, in the current structure, where the conversion index is increased at the same rate for all medical procedures, there is a limitation that medical procedures with higher relative value scores are already subject to a larger increase.

“There is a problem that compensation imbalance is deepening as already highly valued acts, such as imaging and biopsy tests, are increased more significantly, and relatively undervalued essential medical acts, such as surgery and treatment, where human resources are mainly invested, are raised less,” said Cho Chung-hyun, head of the Health Policy Division at the Ministry of Health and Welfare.

However, the medical community is opposed to the “differentiation of the conversion index.” Since the start of this year's negotiations on medical care benefits in May, the KMA argued for a 10 percent across-the-board increase in the benefits, saying, "The problem is that the benefits are generally low regardless of medical practice." It is also reported that, in this month’s review committee, the association strongly opposed the differential application of the conversion index, saying, “The differential application of the conversion index would destroy the benefit system that has been maintained for 20 years.”

Meanwhile, a bill to inject about 189 billion won into the health insurance fund to respond to medical disruption caused by the resignation of trainee doctors was also approved on the same day.

※This article has undergone review by a professional translator after being translated by an AI translation tool.