J Korean Med Assoc.  2013 Oct;56(10):881-890. 10.5124/jkma.2013.56.10.881.

Payment reform for the improvement of primary care in Korea

  • 1Institute for Health Insurance Policy Research, National Health Insurance Corporation, Seoul, Korea.
  • 2Gachon University Gil Medical Center, Incheon, Korea.
  • 3Department of Family Medicine, Catholic University College of Medicine, Seoul, Korea.
  • 4Graduate School of Public Health, Seoul National University, Seoul, Korea. tjlee@snu.ac.kr


Strengthening primary care has always been a major policy issue in most developed countries to achieve the health care system's goals, and policy makers continuously try to use payment system as an effective tool to improve overall performance of primary care. In this paper, we examined the various payment methods and growing trends in primary care payment system in some developed countries. Overall, a common form of payment for primary care doctors is a blend of fee-for-service (FFS), capitation, and pay-for-performance (P4P). In addition, many countries are still in the way of many new trials to find the right way to provide primary care service effectively, to meet the complex health care needs of populations. In Korea, primary care system is not well-established, and other institutional arrangements are not in good conditions for primary care, either. FFS, which is a dominant payment method in Korea, is not favorable for achieving good attributes of primary care. Mixing various payment components, like capitation, P4P to current FFS is essential to provide the optimal incentive structures for primary care physicians. Also, new models to encourage doctor-patient relationships with appropriate P4P mechanisms could be used as an early step in reforming primary care payment system gradually.


Primary health care; Payment system; Fee-for-service plans; Capitation; Reimbursement, incentive
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