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Our economic projections presented in Chapter 4.3 were constructed on the premise
that the health system would fully subsidise all follow-up management services in the
private sector, as well as inpatient care in the public sector. Our initial model showcased
that even if the health system took on full financial responsibility for the health of
citizens, there would still be significant savings accrued from early detection and
management of chronic conditions.

Results from our public polling survey in Chapter 4.2 indicate that most individuals
would be receptive to a service fee ranging between HKD 51–200 per visit to a private
sector provider for management. Therefore, the Scheme should have flexibility to a
range of patient-facing payment responsibilities, particularly for financially vulnerable
individuals. It is incumbent upon the Government to determine a pay scale for
individuals experiencing financial difficulties and to ensure that such patients are
financially capable of maintaining a continuum of care with the private sector family
doctor of choice.

With reference to co-payment schedules in voucher schemes under the Social Welfare
Department, the Government could create a co-payment schedule based on the
Median Monthly Domestic Household Income (MMDHI) released by the Census and
Statistics Department within the latest quarter at the time of the Scheme and annually
revise these figures in accordance to the Composite Consumer Price Index (SWD,
2021). In line with UHC goals, the Government should study the design of co-payment
schemes, if applicable, to ensure financial protection of all individuals participating
in the Scheme, especially for the close to 870,000 people with incomes below 60% of
the MMDHI, a statistic based on the Hong Kong Poverty Situation Report (C&SD, 2020b).

2. The Government and purchaser should consider compiling a list of essential
medications for the care and management of HDH and common
co-morbidities. Furthermore, the Government and purchaser should actively
involve patients and community members when developing the inclusion list
and payment method for these drugs, paying attention to prospective users’ financial
capacity, to ensure that both parties’ needs are being met during the Scheme’s
implementation.

3. Ensuring that citizens’ perspectives can be accounted for when determining the
benefits package is also a crucial element of strategic purchasing. Therefore, the
Government may consider conducting public polling on a regular basis to
better understand the needs and wants of the public. Regularising efforts
to better grasp the public’s perceptions, attitudes, and behaviours toward health
services will promote citizen empowerment by providing a platform for citizens to reflect
their experiences with programmes and express their views and values.

4. We recommend that citizens be further empowered in being informed about their health
and care options, which can be facilitated by improving the accessibility and user
experience of the eHRSS and the newly introduced eHealth App, and enhancing the
education of its features to ensure patients’ enrolment and best use of the eHealth App
to view their health records and record their health status. Mirroring our 2018 report
recommendations, positioning the patient as an “integrator of services” and
ensuring their access to and ownership of their health records are
important to enable person-centred care.

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