pLOG

2024-07-12

How to Promote Patient Support Programs in Taiwanese Hospitals to Help Patients

Taiwan's National Health Insurance (NHI) system provides extensive medical coverage, but with rising healthcare costs, some patients still face economic difficulties when it comes to self-paying for medications. Promoting Patient Assistance Programs (PAPs) can further alleviate financial pressures on these patients and enhance accessibility to new medical treatments. However, it is crucial for hospitals to understand and assist patients with these support programs. From clinical treatment to simplifying application processes, and actively providing information on patient support, hospitals can achieve better healthcare and financial assistance outcomes.

1. The Importance of Medication Support Programs:
Despite Taiwan's National Health Insurance (NHI) covering a significant portion of medical expenses, some patients still face high out-of-pocket costs for expensive new medications and treatments.
Patient Assistance Programs (PAPs) can provide essential financial support for patients who cannot afford the full costs, thereby alleviating their burden of accessing necessary treatments.

2. Challenges Faced by Hospitals:
In Taiwan's hospitals, scenarios where patients are unable to receive treatment due to financial difficulties are relatively rare, thanks to the support provided by the National Health Insurance (NHI), which covers most standard treatments. Therefore, hospitals generally have a low rate of bad debts.
However, for treatments that require out-of-pocket expenses, patients' ability to pay becomes a critical consideration. Patients must sign a consent form for self-payment, acknowledging the financial burden before proceeding with the treatment. Yet, hospitals face challenges in pricing differentiation based on patients' financial capabilities, making collaborative decision-making on treatment recommendations and options a necessary practice in clinical care.

3. Increasing Awareness and Reducing Disparities:
Many patients lack awareness of patient assistance programs (PAPs) or face difficulties accessing information. Some may believe they do not qualify for assistance. This lack of awareness poses a significant barrier to the promotion of these programs.
Patient support programs have traditionally been associated with charity or benevolent initiatives. However, with evolving market dynamics, PAPs now primarily aim to assist the general public with medication support, rather than exclusively targeting low-income households. These programs align with disease-specific medication and treatment guidelines, providing support when treatments are not covered by health insurance.
Hospitals are encouraged to promote and educate patients about their potential eligibility for these programs. This ensures that patients have sufficient information during treatment decisions.

4. Streamlining Application Processes:
Meeting clinical procedures and obtaining physician-prescribed consent, along with necessary medical records and medication information, is crucial for applying to patient support programs. Given the requirements for medical data privacy and compliance, the application process can be complex. Patients often need assistance to complete application forms and provide required documentation, creating an additional barrier to healthcare access.
  Simplifying and digitizing application forms can streamline the process. Digital data exchange can verify necessary information for program approval, prioritizing patient-centric approaches that enhance clinical integration and reduce delays in healthcare delivery.

5. Proactive Patient Eligibility Screening:
Hospitals can enhance collaboration with patient support programs by integrating financial medication costs, prescriptions, and program criteria screening. This allows eligible patients to have PAP applications initiated by physicians, ensuring their right to treatment is safeguarded. However, this approach necessitates adjustments in medical information systems to integrate medication plans into patient medical records.

6. Legislative Trends and Policy Applications:
It is recommended that Taiwan considers adopting practices from other countries to address the limitations of health insurance subsidies. Including patient support program applications in policy considerations and providing clear administrative guidelines can enhance the efficiency of market operations. Public-private partnerships in new drug policies can better manage patient-paid medications and facilitate transitions during health insurance application periods, thereby improving patient care.

7. Hospital Social Responsibility and Mission:
Providing equitable healthcare is a crucial part of hospitals fulfilling their social responsibility. In addition to community care and support for low-income households or special populations, integrating patient support programs to mitigate financial toxicity can not only enhance patient health outcomes but also improve hospital reputation and satisfaction levels.

─ PatientForce Chairman and President Sean Chang