Neighborhood clinics in South Korea will move beyond treating illness to managing residents' everyday health as "family doctors." Physicians will work in teams with nurses, dietitians, physical therapists and social workers to manage chronic conditions and provide counseling on exercise, diet and medication. When needed, the teams will refer patients to specialists, hospitals or community care services.
The Ministry of Health and Welfare said on the 28th that it will launch the Community Primary Care Innovation Pilot Program at 120 neighborhood clinics nationwide starting on the 29th. The program aims to build what the ministry calls a Korean-style family doctor model by expanding the role of neighborhood clinics from treatment to prevention and health management, in response to rapid population aging and rising chronic disease.
The 120 clinics were selected from 674 that applied. Twenty will form their own teams of physicians, nurses, dietitians, physical therapists, occupational therapists and social workers, while 100 will deliver services in partnership with outside hub support institutions.
The program targets local residents aged 50 and over who need health management. Those who register at a participating clinic can receive both in-person and remote health management services tailored to their condition, in addition to regular medical care.
If a health checkup turns up warning signs such as elevated blood pressure or blood sugar, for example, the clinic will not stop at explaining the results but will follow through with ongoing management. Patients can receive counseling on eating habits, exercise methods and proper medication use, and if more specialized treatment is judged necessary, they will be referred to a clinic or hospital with a specialist. Depending on the patient's situation, home visits by doctors or nurses and links to community care services are also available.
Taking part in the program does not mean higher medical bills. Registered patients pay the same out-of-pocket share as before.
The most notable change in the program is how medical institutions are paid. Until now, payment has centered on fee-for-service, under which providers are paid each time they perform a medical act such as an examination, test or procedure. The pilot will instead apply a bundled payment that compensates providers for a set period of health management, taking into account factors such as the patient's health status.
Bundled payments will apply to primary care services such as education and counseling, and medical institutions may also choose the bundled method for examinations, tests and procedures. Operating costs needed for multiple professions to manage patients together, along with rewards based on patient management outcomes, will be paid separately. The aim is to compensate medical institutions not only for treating disease but also for continuously managing patients so that they do not fall ill.
The pilot will run for about three years. Depending on the results, the ministry plans to expand the number of participating institutions and to consider whether to make the program permanent.
"We will build a Korean-style family doctor model that both the public and medical institutions can trust, laying the groundwork for making it a permanent system," said Ko Hyung-woo, director general for regional and essential health care policy at the ministry.
