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Population 23.54 million Land area 36,197 km2

Elderly population (65+) 13.2%GDP per capita (Nominal)GDP per capita (PPP) NHE per capita (2015)

US$ 22,384 (2015)US$ 48,100 (2017 est., from CIA) US$ 1375

NHE to GDP (2015) 6.1% Crude birth rate (2016)Crude death rate (2016)

8.9‰ 7.3‰

Infant mortality (2015)Maternal mortality (2015)Life expectancy (2015)

4.1‰ 11.70/000080.2 (Avg.) / 83.6 (F) / 77.0 (M)

Source: Ministry of the Interior, Ministry of Health and Welfare

Outline

3

Introducing Taiwan’s Health System NHI Reform and Innovation Long-term Care Future Prospects

4

Health Care System

Tertiary Care

Local Hospitals

Regional Hospitals

Clinics

Medical Centers

Functions Tasks

Secondary Care

Vertical Integration(Physicians and Hospitals)

Physician-Patient Relationship

Primary Care

19

81

384

19,771

Seamless Integrated

5

Health Care Delivery System Private sector predominates Closed-staff model No gatekeeper system High-volume hospital outpatient services No waiting lists

27%73%

Hospitals Clinics Beds

Public PrivateData:2015

6

Major Social Insurance Programs

1995

1985

1958

1950 Labor Insurance

Government Employee Insurance

Farmers Insurance

National Health Insurance

2013 Second-generation NHI

Only 59% of the population was covered by public insurance plans in 1994, with children and elders most likely to lack coverage.

National Health Insurance Coverage Compulsory enrollment for all citizens and legal residents

(99.9% of the population is covered by NHI)

Administration Single-payer system run by government

Financing Premiums, co-payments

Benefits Uniform package, comprehensive benefits

Providers 93.5% of Taiwan’s care providers contract with NHI

Payment Plural payment programs under global budget payment systems

Privileges Premium subsidies and co-payment waivers for the disadvantaged

Satisfaction 83.1% (2016)

7

Health IT - NHI Card

8

Simplifies management process

Medical visit dataupdated daily

Infectious disease tracing & monitoring

Heavy-user detection & management

1. Last six medical visits2. Drug prescriptions, drug

allergies3. Catastrophic diseases4. Organ donation consent5. Palliative care consent

Health IT - NHI Medi-Cloud System

Rehabilitation Care

Specific Medications (Controlled Drugs)

Drug Allergies

Chinese Medicine

NHI Medi-Cloud System

Examination Records

Surgical Records

Dental Services

Reports & Lab Data

Discharge Summaries

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PharmaCloud

Established in 2014, expanded in 2016 3 years of medical data Health information is shown as diagrams to enhance readability Provides educational guidelines Simplifies patient access to records Provides prognoses and evaluations for certain diseases

Health IT - My Health BankMy Data, My Decision

My Health Bank App

Care That Reaches Every Community

50 plans to improve services in mountain areas and offshore islands

Telemedicine & helicopter service for virtually every island

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Growing Elderly Population

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1993 20252018

41.0%

super-agedagedageing

65+

80+

0

10

20

30

40

1981 20612041 20512006

People older than 65 years (%)

85+

10.5%

17.7%

20.1%

14.6%

7.1%

••

•

Source: Economic Development estimates (2014 to 2061)

Evolution of Long-term Care

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1998

Expanded Elderly Nursing Services Program & 3-Year Elderly Long-term Care Plan

2000-2003

Long-term Care Pilot Plan

2002-2007

Care and Welfare Plus Industry Development Program

2008

10-year Long-term Care Plan 1.0

2015Long-termCare Services Act

10-Year Long-term Care Plan 2.0

2017

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Medical Care

Care

Life support and prevention

Home care

When you need care…When you are sick..

Healthy living

LTC management center

Acute, sub-acute and rehabilitation medical services

Clinics, hospitals in the living area

Outpatient 、hospitalization

Establish A-B-C modelA- Integrated Community Service Center B- Multiple Service Center C- Long-term Care Station

Receive services at home

Assess needs of disabled

Provide transportation services regularly in small area

Holistic Community Care Model

Day care, family support services, community rehabilitation service, dementia care stations, welfare services for the disabled

Integrate health care and long-term care service

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Prevent frailty

Integrated home care

service

Discharge preparation

1.Muscle strengthening exercise

2.Life rehabilitation training

3.Social participation4.Oral health5.Nutrition and diet6.Knowledge

promotion

1.Discharge program2.Evaluate case needs3.Assist in the referral

of NHI family physician with integrated care program in the community

1.Basic home care2.Severe home care3.At-home hospice

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Challenges and Strategy of LTC 2.0

Challenge 1. collaboration between public and private resources

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1. Priority is placed on expanding homecare service capacity.

2. Popularize day-care centers3. Develop A, expand B, and build

more C

Central government

Inter-ministerial collaboration

Designate policies, legislations, and utilization of public spaces

Local government

Execute strategy from central government

Service unitsProvide LTC services

Subsidy Review program

PaymentExpense report

Local financial resource planning, monitoring of LTC

institutions

Challenge 2. Speed up the development of long-term care human resources

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1. Adjust course modules to increase hours of internship

2. Enhance academic and industry collaboration

3. Supply 10% of the manpower needed

1. Increase level of salary2. Plan career development of care service

personnel3. Retain trained personnel4. Satisfy 40% of the needed manpower

Utilization

Study Training1. Local government organize

local training2. Adjust care service

personnel course contents3. Estimated to satisfy 50% of

the manpower needed

Challenge 3. Reform the long-term care payment and expense

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From commissioned to contracted; simplify the process workflow

Multiple assessment tools：Utilize evaluation tools to comprehensively assess the cognitive and physical function of the cases

Standardized payment condition：8-tier payment system based on evidence based data pertaining to different mental and physical function, disability, and cognitive impairment

Case centered approach, payment in lump sum or fixed batch payment

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Conclusion

Through the LTC 2.0 We wish to

Establish community based long-term care system

ANDProvide quality and affordable service

• Social care and services

• Social insurance• Target groups

Promote Health and Well-being

Industry

Medical Services

HHealth

Happiness

Equality

Sustainability

• Health care system• Long-term care

system• Prevent

communicable diseases

• Food and Drug Administration

• Supportive environments

• Healthy lifestyles• Lifelong health

Social Welfare

• Industrial development• Technological development

and medical research• International medicine• International cooperation Health

Promotion

Health 2025 Goals and Core Values

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Thanks for your attention!