The Ministry of Health and Welfare and HIRA said that starting on the 3rd they will disclose prices for 753 noncovered medical services at 74,449 medical institutions nationwide through HIRA's website and the Health e-um mobile app.
Noncovered services are items not covered by health insurance, so patients pay the full cost. Because prices can vary widely by hospital even for the same treatment, the government releases price information every year so patients can check prices in advance and choose a medical institution.
This year's disclosed items increased by 60 from 693 last year. Corneal cross-linking, radiowave hyperthermia and hyperthermia planning were newly included, and existing items such as robot-assisted surgery were made more detailed. Starting this year, patients can also check price information for medical supplies related to medical procedures.
◇ Price gaps even for the same treatment
Price gaps for noncovered services stand out by medical institution.
For extracorporeal shock wave therapy, a representative noncovered item, the median price at clinics was 70,000 won, but the highest clinic price was 175,000 won, 2.5 times the median. This treatment applies shock waves externally to reduce musculoskeletal pain and is used for the back, shoulder, elbow and plantar fasciitis.
Prolotherapy also showed large price differences. A clinic in Seoul presented 50,000 won as the median price, but a clinic in North Gyeongsang charged up to 201,000 won. For renal injection therapy, some clinics had a median price of 20,000 won, while the highest price was 55,000 won.
By contrast, the influenza A and B virus antigen test (point-of-care test), which many flu patients receive, had a relatively small price gap. A clinic in North Jeolla had a median price of 30,000 won, while a clinic in Gwangju had a highest price of 35,000 won.
Dental implants also had wide price variations. For zirconia implants, a dental clinic in South Gyeongsang had a median price of 1.1 million won, but a dental clinic in Seoul set prices as high as 1.72 million won.
However, it is difficult to conclude that price differences by medical institution are simply because hospitals charge more. Prices can vary depending on the details or complexity of care, and the staff and equipment used.
◇ Average prices for noncovered services up 73.5%
How did overall noncovered prices change? Comparing 593 items disclosed in both last year and this year, the average prices of 436 items (73.5%) rose. The number of items with lower average prices was 146 (24.6%).
However, considering that the consumer price index rose 3.2% from June last year to June this year, the Ministry of Health and Welfare analyzed that the real average prices of 448 items (75.5%) among the 593 fell. Although many noncovered items saw nominal price increases, more items effectively became less burdensome when overall inflation was taken into account.
Price gaps among medical institutions remained substantial. Compared with last year, the spread widened for 337 items (56.8%) and narrowed for 242 items (40.8%).
Looking at price changes for major noncovered items, the average price of extracorporeal shock wave therapy this year was 77,900 won, up 1.9% from 76,500 won last year. The average price of prolotherapy was 64,400 won, up 0.9% from last year. Renal injection therapy was 25,500 won, up 2.0%.
The average price of dental implants was 1,181,000 won, down 0.9% from last year. The average price of the influenza A and B virus antigen test was 27,400 won, unchanged from last year.
Among noncovered items, those frequently performed at actual medical institutions are also disclosed. At clinics, flu rapid tests and vaccinations are representative; at hospitals, private-room surcharges for single rooms and manual therapy are representative. In dentistry, composite resin fillings and crowns, and at Korean medicine clinics, pharmacopuncture and chuna therapy, were counted as items with many operating institutions.
◇ "Compare prices before getting treatment"… manual therapy under managed benefits
The government is also strengthening oversight of noncovered care.
The Ministry of Health and Welfare converted manual therapy to a managed benefit item starting in July this year. For extracorporeal shock wave therapy, the medical community established criteria such as indications and number of sessions through voluntary corrections.
Managed benefits are a system that manages prices and clinical criteria for items such as noncovered services with high patient cost sharing, even though they are covered by health insurance. The government plans to expand the scope of managed benefits to reduce excessive noncovered care and lower patients' medical expenses.
Consumers can search noncovered prices by medical institution on HIRA's website and the Health e-um app. In addition to prices, they can also check results of medical technology re-evaluations on the safety and effectiveness of the noncovered service and the reimbursement criteria.
Yu Ju-heon, director general for health insurance policy at the Ministry of Health and Welfare, said, "The noncovered price disclosure system guarantees the public's right to know and supports rational use of noncovered services," adding, "We will gather feedback from consumers and the medical community to improve the system."