Digital Technologies For Government Supported Health Insurance Systems In Asia And The Pacific

This report explores digital solutions that can support the core business processes of public health insurance operators in Asia and the Pacific. Examples from low- and middle-income countries in the region and beyond are drawn to demonstrate how digital solutions have improved health insurance management and administration. To support decision-making on potential investments, the report identifies key success factors for integrating new technologies into public health insurance schemes.

This open access book introduces the National Health Insurance (NHI) system of Taiwan with a particular emphasis on its application of digital technology to improve healthcare access and quality. The authors explicate how Taiwan integrates its strong Information and Communications Technology (ICT) industry with 5G to construct an information system that facilitates medical information exchange, collects data for planning and research, refines medical claims review procedures and even assists in fighting COVID-19. Taiwan's NHI, launched in 1995, is a single-payer system funded primarily through payroll-based premiums. It covers all citizens and foreign residents with the same comprehensive benefits without the long waiting times seen in other single-payer systems. Though premium rate adjustment and various reforms were carried out in 2010, the NHI finds itself at a crossroads over its financial stability. With the advancement of technologies and an aging population, it faces challenges of expanding coverage to newly developed treatments and diagnosis methods and applying the latest innovations to deliver telemedicine and more patient-centered services. The NHI, like the national health systems of other countries, also needs to address the privacy concerns of the personal health data it collects and the issues regarding opening this data for research or commercial use. In this book, the 12 chapters cover the history, characteristics, current status, innovations and future reform plans of the NHI in the digital era. Topics explored include: Income Strategy Payment Structure Pursuing Health Equity Infrastructure of the Medical Information System Innovative Applications of the Medical Information Applications of Big Data and Artificial Intelligence Digital Health Care in Taiwan is essential reading for academic researchers and students in healthcare administration, health policy, health systems research, and health services delivery, as well as policymakers and public officials in relevant government departments. It also would appeal to academics, practitioners, and other professionals in public health, health sciences, social welfare, and health and biotechnology law.

East Asian and Pacific countries are growing rapidly. They need high quality, well-funded health systems to underpin their population growth and assure continued productivity and economic growth. But countries will need to spend wisely, using modern techniques of insurance and strategic contracting with providers.

This report highlights how financial technology or fintech can be leveraged to improve health systems and outcomes. A “Fintech for Health” approach integrates digital financial services with health innovations to help solve health-care affordability, quality, and access challenges. It can be powerful in enabling people to gain access to health care and in preventing health-related bankruptcy. The report draws on examples of this approach from Indonesia, the Philippines, and Singapore. It considers the enabling environment, challenges, future opportunities, and how Fintech for Health can be adapted to diverse contexts to help promote universal health coverage.

This guide provides resources for the planning and implementation of health systems in Pacific island countries to support improved decision-making and service delivery. With increased internet connectivity, Pacific island countries have more opportunities to connect remote health facilities for greater information exchange. This guide draws on experiences from Pacific island countries that have already invested in digital health and brings together practical tools and resources to support all stages of digital health planning and implementation. It includes extensive contributions from practitioners, government staff, and development partners in the Pacific health sector.

Digital health is a rapidly expanding area of interest for both research, policy and practice, and within that area digital technologies (DTs) for health financing receive increasing attention. DTs can change the nature and business processes of health financing functions and tasks and modify the interactions between health financing actors. Depending on their design features and actual implementation as well as broader contextual factors, DTs can affect the health financing tasks and functions (positively or negatively). However, little robust evidence exists on the impact of DTs specifically on health financing and universal health coverage (UHC) objectives. More rigorous evaluations in this area is urgently needed. The aim of this guide is to support the evidence generation on DTs for health financing. The guide provides orientation to analyse a country use case of digital technology and its (positive and negative) effects for health financing, i.e. whether, how and why it contributes to the realization of desirable health financing attributes and UHC intermediate and final objectives or whether, how and in which circumstances it is actually harmful to these.