[1] Since its foundation, its role has expanded as it has become a specialised agency with delegated powers related to health insurance and healthcare from the Ministry.
[5][6] Health Insurance Review & Assessment Service (HIRA) ensures to build a sustainable and high-performing healthcare system in Korea.
• Design and implement the healthcare provider payment systems • Design the health benefits package • Conduct the claims review to evaluate healthcare costs • Re-review claims and providers via a follow-up review and on-site investigation • Use Quality Assessment to improve quality of care • Encourage providers to take more steps toward quality improvement • Designate tertiary hospitals with quality assessment results • Collect, Connect, and Utilize nationwide data in healthcare • Play a key role in creating added value - Drug Management (KPIS / DUR) - Health Resources Management - Healthcare Utilization Monitoring Dashboard • Collaborate with various international organizations • Provide consultation and capacity-building programs - Expert Consulting - Capacity Building Program Building off of the MERS crisis in 2015, laws and systems were put in place to rapidly respond to the threat of emerging epidemic outbreaks.
With data from patients and providers nationwide, HIRA contributes to preventing spread, detecting and treating cases early, and responding quickly to the surge capacity of the healthcare system.
- Detection of high-risk groups using DUR/ITS - Expanding health benefits package rapidly - Responding quickly to surge capacity through resource reallocation - Stabilizing the protective face mask supply - “National Safe Hospital” designation (COVID-19 Protection Hospital) - National COVID-19 Patient Data Repository - COVID-19 Global Research Collaboration Platform Source:[7]