Applause for Local Governments... Ulsan Namgu's Secret to Curbing Medical Aid Waste

Reduced Medical Aid Costs by 55% through Customized Outpatient Care Management
Secured Financial Soundness by Saving Over 500 Million During Difficult Times

Ulsan Nam-gu Office building. Nam-gu significantly reduced medical aid costs through customized case management.

[Asia Economy Yeongnam Reporting Headquarters Reporter Kim Yong-woo] Even though they know that medical services that should be used by those who truly need them are being wasted unnecessarily, they turn a blind eye, thinking it is not their responsibility. In reality, national medical benefits have become blind money that can be recklessly spent by hospitals or patients at the state's expense.

There is a local government that reduced medical benefit costs by as much as 530 million won through the "masterstroke" of customized case management of medical services. This is the story of Nam-gu, Ulsan.

On the 15th, Nam-gu, Ulsan announced that it saved a whopping 530 million won in medical benefit costs through customized case management for patients who excessively used outpatient services among medical benefit recipients.

Nam-gu reduced medical expenses for about 5,400 total recipients of the National Basic Livelihood Security medical benefits from 1 billion won the previous year to 440 million won, a 55% reduction.

Moreover, in a situation where national debt due to the response to the novel coronavirus disease (COVID-19) is becoming more critical, such unnecessary cost savings have value beyond just applause for celebration.

Medical benefits, a social security system provided with taxpayers' money, allow recipients to receive medical services with lower out-of-pocket costs compared to health insurance, raising concerns about moral hazard such as drug misuse and medical shopping.

Nam-gu has been identifying the usage patterns of hospitals and clinics by medical benefit recipients through the Medical Benefits Comprehensive Information Support System to prevent misuse and overuse of medical services, and has been conducting individual and in-depth case management and education for the targeted recipients.

Additionally, Nam-gu assigned medical benefit managers with expertise in the medical field to the Elderly and Disabled Department to monitor irrational medical use such as duplicate prescriptions, excessive drug receipt, and medical shopping. Thorough investigations were also conducted on cases of long-term hospitalization not for treatment purposes.

To enable more efficient use of medical benefits, information on medical benefit support and hospital/clinic medical benefit day management methods was provided to chronic patients, long-term hospitalized patients, and cancer patients, and active efforts were made to promote individual health management of recipients and national health screenings.

These efforts cut medical benefit costs by more than half. Nam-gu will hold group medical benefit education sessions on the 29th and 30th, which had been postponed due to COVID-19. This reflects their determination to prevent even momentary leakage of national budget.

Kim Ju-hee, a medical benefit manager in Nam-gu, Ulsan, said, “Through case management and education for medical benefit recipients, we are guiding appropriate medical use and preventing drug misuse and excessive treatment, thereby helping recipients lead healthier lives. We will do our best to ensure that medical benefit finances are used for those who truly need them.”

This content was produced with the assistance of AI translation services.