주요국의 지불제도 개편 동향 연구: 지속가능한 의료보장을 위한 지불제도 개편을 중심으로

Abstract

This study aims to offer suggestions for payment system reform in Korea based on understanding of recent discussions around payment system in the international society and current trend of reform in major countries. First of all, we examined the role, type, and reform trend of the payment system discussed in major international organizations, such as WHO and OECD. And then, we reviewed the reform trend of the payment system in countries that have recently carried out payment system reform, such as the United States, United Kingdom, Australia, and Japan. These countries have applied a variety of new payment models, including Bundled Payment System, Performance-based Payment System, and Population-based Payment System referred to as Accountable Care Organizations(ACOs) to make a transition to a value-based payment system where quality of care and efficiency are considered top priorities. It is time for Korea to begin a lively discussion to prevent the potential crisis of fund sustainability in healthcare, and payment system reform can serve as the important policy lever. The current payment system needs to reinforce flexibility and diversification in terms of payment methods. Although such change should come without bringing disruption to Fee-for-service, the main payment system of Korea, the reform should be able to put experimental application of alternative payment system into place where stakeholders would want to voluntarily take part in.