Korean J Fam Pract.  2023 Mar;13(1):2-7. 10.21215/kjfp.2023.13.1.2.

Changes in the Mixed Fee-Based Payment System in Primary Care: Cases and Implications

• Lee H

• KMID: 2540639
• DOI: http://doi.org/10.21215/kjfp.2023.13.1.2

Abstract

Payment systems have a significant impact on the behavior of both healthcare providers and users. There are various payment methods such as fee-forservice, payment per case or diagnosis-related group, capitation, global budget, and pay-for-performance. This study investigated the payment systems used in primary care overseas in order to identify potential payment systems that can be introduced in primary care in Korea. With an aging population, the primary care system in Korea is in constant need of change. In this context, effective coordination between medical care, social care, and medical institutions is essential, and many countries have already improved their payment systems to address this challenge. For example, the primary healthcare payment system in the United Kingdom combines fee-for-service and pay-for-performance, with a focus on capitation. Similarly, the United States is gradually transitioning from a fee-for-service to a blended payment system through pilot projects. In Korea, blended payment was introduced through primary care pilot projects, but it is not yet universally applied to primary care. To provide value-based primary care in Korea, it is crucial to implement payment system reforms and designate a primary care physician.

Keyword

Payment System; Bundled Payment; Blended Payment; Primary Care