ENHANCING HEALTH CARE SYSTEM RESILIENCE AND FINANCIAL SUSTAINABILITY: THE ROLE OF PAYMENT MODELS AND INTERNATIONAL PATIENT LOYALTY IN A SOUTHERN TAIWAN MEDICAL CENTER
Author(s)
YI NING SU, MBA1, Yung-Sung Yeh, Doctor of Medicine2, Yu-Tang Chang3.
1International medical service center, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan, 2Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan, 3Kaohsiung Medical University Chung-Ho Memorial Hospital, Taiwan.
1International medical service center, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan, 2Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan, 3Kaohsiung Medical University Chung-Ho Memorial Hospital, Taiwan.
OBJECTIVES: To evaluate the impact of different payment models (International Insurance, National Health Insurance [NHI], and Self-payment) and the implementation of a structured word-of-mouth (WOM) referral system on patient loyalty and healthcare system financial sustainability within an international medical center in Taiwan.
METHODS: A retrospective cohort study was conducted analyzing outpatient data ($n = 2,357$) from Kaohsiung Medical University Hospital between August 2020 and May 2025. Participants were divided into Group A (Pre-intervention: Aug 2020 - July 2022) and Group B (Post-intervention: Aug 2022 - May 2025, following the introduction of a multilingual WOM system). A modified LRFM framework (Length, Recency, Frequency, Monetary) was utilized to quantify patient loyalty. Statistical significance was assessed using t-tests and chi-square tests to compare outcomes between groups and payment types.
RESULTS: Post-intervention (Group B), annual international patient visits increased significantly from $420 \pm 65$ to $660 \pm 80$ ($p=0.021$). The composite LRFM score improved from $11.2 \pm 2.1$ to $14.3 \pm 1.8$ ($p<0.001$), with the proportion of "high-loyalty" patients doubling from 6% to 13% ($p=0.006$). Significant improvements were noted in:Recency: Reduced from $142 \pm 28$ to $107 \pm 24$ days ($p=0.012$).Monetary Value: Increased from NT$6,480 to NT$7,250 ($p=0.037$).
Payment Model Shift: Insurance-paid cases rose from 38% to 54% ($p=0.018$).
Patients under Insurance and NHI models demonstrated significantly higher LRFM gains (Insurance: $12.6 \pm 1.9$ to $15.2 \pm 1.4, p=0.004$; NHI: $11.8 \pm 2.1$ to $14.1 \pm 1.7, p=0.009$) compared to self-paying patients ($p=0.087$), suggesting that predictable payment structures enhance long-term engagement.
CONCLUSIONS: Structured WOM systems combined with predictable payment models (NHI and International Insurance) significantly enhance international patient loyalty and institutional financial resilience. These findings suggest that for medical centers, integrating digital referral systems with transparent payment frameworks is a key driver for sustainable health policy and resource optimization in globalized healthcare.
METHODS: A retrospective cohort study was conducted analyzing outpatient data ($n = 2,357$) from Kaohsiung Medical University Hospital between August 2020 and May 2025. Participants were divided into Group A (Pre-intervention: Aug 2020 - July 2022) and Group B (Post-intervention: Aug 2022 - May 2025, following the introduction of a multilingual WOM system). A modified LRFM framework (Length, Recency, Frequency, Monetary) was utilized to quantify patient loyalty. Statistical significance was assessed using t-tests and chi-square tests to compare outcomes between groups and payment types.
RESULTS: Post-intervention (Group B), annual international patient visits increased significantly from $420 \pm 65$ to $660 \pm 80$ ($p=0.021$). The composite LRFM score improved from $11.2 \pm 2.1$ to $14.3 \pm 1.8$ ($p<0.001$), with the proportion of "high-loyalty" patients doubling from 6% to 13% ($p=0.006$). Significant improvements were noted in:Recency: Reduced from $142 \pm 28$ to $107 \pm 24$ days ($p=0.012$).Monetary Value: Increased from NT$6,480 to NT$7,250 ($p=0.037$).
Payment Model Shift: Insurance-paid cases rose from 38% to 54% ($p=0.018$).
Patients under Insurance and NHI models demonstrated significantly higher LRFM gains (Insurance: $12.6 \pm 1.9$ to $15.2 \pm 1.4, p=0.004$; NHI: $11.8 \pm 2.1$ to $14.1 \pm 1.7, p=0.009$) compared to self-paying patients ($p=0.087$), suggesting that predictable payment structures enhance long-term engagement.
CONCLUSIONS: Structured WOM systems combined with predictable payment models (NHI and International Insurance) significantly enhance international patient loyalty and institutional financial resilience. These findings suggest that for medical centers, integrating digital referral systems with transparent payment frameworks is a key driver for sustainable health policy and resource optimization in globalized healthcare.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HSD52
Topic
Health Policy & Regulatory, Health Service Delivery & Process of Care
Disease
No Additional Disease & Conditions/Specialized Treatment Areas