Sustainable National Health Insurance participated by all
Policy
1. Our service ideals
National Health Insurance has now entered its twelfth year. Our goal of this year is to "maintain stable finances, improve medical quality, make the payment system more efficient, expand public participation, and strengthen internal controls" in line with our basic philosophy of "building social consensus, protecting the right to medical care, improving service quality, and promoting international cooperation." Apart from continuing to uphold the basic philosophy of NHI, this branch will also take "fairness, quality, efficiency, and concern" as our operational group watchwords, work hard to further the mutual interests of the insured individuals, group insurance units, and medical service organizations within our service area.
2. Focal points of our work in 2006
Our branch will take "fairness, quality, efficiency, and concern" as the benchmarks for our work in 2006. We plan to adopt the following specific strategies:
(1) Fairness
Our service area encompasses the six cities and counties of Taipei city, Taipei county, Keelung City, Ilan County, Kinmen County, and Lienchiang County. We serve over eight million insured individuals and more than 7,000 specially contracted hospitals and clinics. We provide one-third of all NHI services in Taiwan. It is obvious that we must correctly collect premiums and provide insureds with a high-quality, convenient medical environment if we are going to accomplish our mission of fairness. Actions we are taking to maintain fairness include:
(1) In order to ensure a stable revenues from premiums and protect the public's right to medical care, we will strengthen audits of payroll-related premiums and reminding members of the public who have interrupted their enrollment that they must pay for over payments.
(2) In order to provide fair medical quality and quantity to insureds, we will use the systematic and computerized audit mechanisms accompanying our health insurance IC cards to give people who overuse medical resources a correct health care outlook, while also rigorously detecting and auditing unscrupulous hospitals and clinics that dishonestly report expenses.
(2) Quality
We are working to serve insureds by improving medical quality and maintaining information transparent. We are taking the following actions to improve quality:
(1) In order to enhance medical accessibility and continuity for the public, we will continue to promote community medical teams and strengthen referral mechanisms between hospitals and clinics at all levels within our service area.
(2) We will strengthen the medical quality in remote mountain areas and offshore islands; apart from continuing to provide medical care and add preventive care services, we hope to instill the concept of "prevention is better than cure" among local residents.
(3) We will establish a website interface provided more convenient access to information, ensuring that the public can obtain needed medical quality information.
(4) In order to ensure the reasonableness and accuracy of payments, we will continue monitoring the quality of the global payment system and the effectiveness and reasonableness of utilization.
(3) Efficiency
We are dedicated to providing convenient and efficient services. We are implementing effective internal controls, and look forward to concretely realizing high-quality, high-efficiency public services. We consider our mission to be "starting from inside out, beginning from heart and mind, we are purifying ourselves." Our key efficiency-raising tasks for this year include the following:
(1) We will establish superior service center; this convenient service center will boost public satisfaction with an all-new look, efficient work processes, and superior service teams.
(2) We will establish excellent information handling platforms and convenient information tools, simplify work processes, and reduce the public's waiting time and effort spent results from making unnecessary trips.
(3) We will reinforce our information and communications security mechanisms in order to prevent criminal groups or unscrupulous parties from committing fraud in the name of health insurance.
(4) We will establish a personnel transfer system and make the most effective use of our human capital; we will encourage colleagues to realize their professional potentials and strive to maximize work efficiency
(5) We will improve the qualifications of our personnel and respond to global health insurance trends by building a learning organization and improving our colleagues' foreign language abilities.
(6) We will promote the "5S activities" in our office environment in order to improve management habits and quality and facilitate overall enhancement of our operating performance.
(4) Concern
The essential spirit of health insurance is intimately linked with the social values of mutual aid/self-help and the awareness that we are all in the same boat. After 12 years of launching the National health insurance program, we are moving to increase social participation and realize our basic value and belief of concern for the underprivileged. Our tasks under the heading of "concern" include the following:
(1) We will implement superior, innovative on-site service items, such as by upgrading hardware and software at our service center in order to offer outstanding public service; we will also establish a "Health Information Exchange Zone" providing value-added health information to internal and external customers.
(2) We will draw on society's resources and make best use of community volunteers, while uncovering cases of underprivileged patients and remaining mindful of our guiding principle of "giving aid in emergencies, but discouraging dependency."
(3) We will make the best use of our branch's Caring Heart Fund so as to benefit truly members of underprivileged groups and ensure that donors' money is well spent.
(4) We will use media broadcasts and special messages to publicize the ways we are realizing our concern and make sure that the public cherishes health insurance resources.
3. Future work directions
We believe that "innovation, humility, and concern" are needed to provide the best possible service quality. Only "innovation" will let us keep up with the times; only "humility" will spur us to respond to the public's diverse needs; and only "concern" will enable us to express our social responsibility. We realize that, since we are located in the greater Taipei area, public demand for broader services and better quality is especially keen. We will accordingly continue to serve insureds with business philosophy of "friendly service, professional operations, and high business efficiency." We will work to complete our tasks for this year and strive to make ourselves the best and most exemplary branch.
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