The National Health Insurance Administration renegotiated per-session dialysis payments with a Kaohsiung clinic network after patients waited an average of eight weeks for chair time, according to a circular hospital administrators received Monday.
The agreement raises reimbursement for nocturnal dialysis shifts by NT$320 per session when clinics keep chairs open past 10 p.m., and it adds a NT$1,200 monthly bonus for facilities that assign dedicated nurses to home hookups inside the metropolitan area.
Why waits stretched
Kaohsiung public health officials said the backlog grew because two hospital wards closed for plumbing retrofits during typhoon season, while demand rose as aging diabetics moved south from pricier Taipei programs. At the worst point in September, 184 patients were queued for first-time chair assignments, triple the level considered manageable.
Patient groups told legislators that home dialysis supplies were sitting in warehouses because reimbursement paperwork took six weeks to clear, discouraging clinics from training caregivers.
What changes on the ground
Under the new schedule, participating clinics must publish weekly vacancy counts on the NHIA’s transparency portal. Facilities that miss the posting lose the night-shift bonus for the following month. The Kaohsiung City Government will loan portable water-treatment units to two satellite clinics in Dashu and Gangshan while permanent plumbing is installed.
Physicians said the payment lift still does not cover full nurse staffing costs, but it makes overnight shifts viable for mid-sized operators that previously sent patients to emergency departments when daytime chairs filled.
Longer reform path
Acting NHIA Director General Chung Shu-ming said the agency will monitor whether the Kaohsiung template can expand to Tainan and Pingtung next quarter. National lawmakers are debating a broader renal-care bill that would fund vascular access surgeries separately from session fees, a change advocates say would prevent clinics from delaying fistula operations for budget reasons.
Chung asked hospitals to report any return to eight-week waits by December 15 or face audit teams.