South Korea is poised to significantly expand its long-term care system with the nationwide implementation of the Integrated Care Act on March 27, 2026. This landmark legislation aims to provide comprehensive, coordinated healthcare and social services to individuals in their homes, particularly the elderly and those with disabilities. However, the rollout in regions like Gwangju and South Jeolla Province is raising concerns about adequate infrastructure and staffing to meet the anticipated demand, especially given their rapidly aging populations.
The Integrated Care Act, officially known as the “Act on the Integrated Support for Regional Care, Medical Care, and Welfare,” represents a fundamental shift in how care is delivered. Rather than relying solely on institutional settings, the law prioritizes enabling individuals to remain in their communities while receiving the necessary support. This is achieved through the establishment of long-term care medical centers, staffed by multidisciplinary teams comprising physicians, nurses, and social workers. These teams will conduct home visits, provide medical treatment, manage care plans, and connect patients with local resources. As reported by the Daum news outlet, the government has mandated that every city, county, and district across the nation establish at least one such center.
Aging Populations and Infrastructure Gaps
While the national mandate is in place, the distribution of these centers is uneven, particularly in areas with the highest concentrations of elderly residents. South Jeolla Province currently has 33 long-term care medical centers, while Gwangju has six. These centers are distributed across the region, with multiple institutions participating in some areas like Gurye, Mokpo, Shinan, Yeongam, Wando, Jangseong, Jangheung, and Hwasun. However, experts warn that these numbers are insufficient to address the needs of the growing senior population. According to Statistics Korea, as of January 2026, 28.3% of South Jeolla Province’s population (503,603 individuals) is aged 65 or older – the highest proportion in the country. This demographic reality is placing significant strain on existing healthcare resources.
Gwangju also faces a rapidly aging population, with 18.8% of its residents (267,530 individuals) aged 65 or older. This figure places the city on the cusp of being classified as a “super-aged society,” typically defined as having 20% or more of the population over the age of 65. The current ratio translates to approximately one center for every 43,000 elderly residents in Gwangju and one center for every 15,000 elderly residents in South Jeolla Province. While the centers primarily serve individuals with long-term care needs (grades 1 and 2), the increasing number of seniors living independently suggests a growing demand for at-home medical services.
Financial Considerations and Workforce Challenges
The financial viability of the integrated care system is also under scrutiny. Reimbursement for at-home medical services is based on a combination of national health insurance and long-term care insurance. Physician home visits are reimbursed at 131,720 won per visit, while long-term care insurance provides a basic monthly fee of 140,000 won per patient, contingent upon a physician visit and two nurse visits. However, healthcare providers express concerns that the current fee structure may not adequately cover the costs associated with multidisciplinary team-based care.
“This is a new initiative, and there will inevitably be areas that require refinement as we move forward,” stated Choi Un-chang, President of the Jeolla-namdo Medical Association. “Long-term care medical centers require the collaboration of physicians, nurses, and social workers, which presents logistical and administrative hurdles for healthcare institutions. The current fee schedule doesn’t fully align with the realities of providing on-site care, and adjustments will be necessary during the implementation phase.” The association is actively working with the provincial government to identify and address these challenges through a dedicated task force.
Expanding the Scope of Care in Gwangju
Gwangju is taking proactive steps to broaden access to integrated care services. The city is expanding financial support for the “Gwangju-daum Integrated Care” program, which will now be fully integrated into the national system. Previously limited to households with incomes below 90% of the median, eligibility has been extended to those earning up to 160% of the median income. This expansion will cover an estimated 77.6% of Gwangju’s population, up from 53.7%. For a single-person household, this translates to an income threshold of 4.1 million won per month; for a two-person household, the threshold is 6.72 million won. While some cost-sharing will apply based on income level – with full coverage for those below 90% of the median, 30% for those between 90% and 120%, and 60% for those between 120% and 160% – the city is maintaining an annual support cap of 1.5 million won per individual. The Gwangju Metropolitan Government announced these changes in January 2026, anticipating the nationwide rollout of the Integrated Care Act.
South Jeolla Province is also implementing a pilot program, the “Jeolla-type Integrated Care Demonstration Project,” to prepare for the full-scale implementation of the law and establish a foundation for expansion across all cities and counties. According to a press release from the Jeollanam-do Provincial Government, this initiative aims to ensure a smooth transition and address regional specificities.
The success of the Integrated Care Act hinges on addressing the critical shortage of healthcare professionals willing to provide at-home care, particularly in rural areas. Recruitment and retention strategies, coupled with adjustments to the reimbursement structure, will be essential to ensure that the benefits of this new system are accessible to all who need them. The expansion of telehealth services and the utilization of mobile healthcare units may also play a role in bridging the gap in access to care.
As the March 27th implementation date approaches, stakeholders are closely monitoring the situation in Gwangju and South Jeolla Province. The experiences in these regions, with their unique demographic challenges, will provide valuable insights for the nationwide rollout of the Integrated Care Act and its potential to transform the landscape of long-term care in South Korea.
The next key development will be the release of initial implementation data and feedback from healthcare providers and patients in April 2026. This information will be crucial for identifying areas for improvement and ensuring the long-term sustainability of the Integrated Care Act. We encourage readers to share their thoughts and experiences with the new system in the comments below.
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