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05-10-2023

CHIF budget will reach almost 3.5 billion next year

Iliustracija

Government approved the draft budget of Compulsory Health Insurance Fund (CHIF) for 2024. Next year, its revenue is expected to be EUR 411.2 million (13.5%) higher than this year, totalling around EUR 3.5 billion.

“The budget of Compulsory Health Insurance Fund will increase significantly next year. There will be enough money not only to enforce decisions already taken, but also to pay for new healthcare services, reimburse new medicines and increase the salaries of staff in healthcare institutions,” Gintaras Kacevičius, the director of the National Health Insurance Fund (NHIF) under the Ministry of Health, says.

Changes in the budget structure

The structure of income and costs of the CHIF budget for the next year is also changing, in line with the Law on Health Insurance, which will change as of 2024. Income of the CHIF budget no longer includes funds recovered and reimbursed as a result of damage caused to the CHIF budget, funds transferred by the Member States of the European Economic Area and the Swiss Confederation for the treatment of insured persons from these countries in personal health care institutions of the Republic of Lithuania, as well as funds transferred under the agreements on the improvement of treatment accessibility and on risk sharing. These funds will be considered as reimbursement of CHIF costs.

In addition, CHIF budget will classify costs for medical rehabilitation and sanatorium treatment as personal healthcare costs, and expenditure on orthopaedic technical devices as expenditure for medicines, medical aids and rental of medical equipment.

CHIF budget will also separately account for the state budget allocations set out in the Law on Health Insurance for the financing of state delegated functions. For example, to pay for services to save and preserve lives (emergency medical care); allocate funds to pay compensation to blood donors and to promote unpaid blood donation; to cover premiums for reimbursed medicines and medical aids (MA) dispensed to the population; to pay for costs that cannot be reimbursed from the CHIF budget.

Increase in income, increase in expense

Simona Adamkevičiūtė, the director of the Department of Economics of the NHIF, states that scenario of economic development, projected by the Ministry of Finances, is beneficial for the growth of CHIF budget income. This is also reflected in the projected change in the amount of compulsory health insurance (CHI) contributions, which increase by almost 18% in the 2024 budget. Compulsory health insurance contributions are the main part of the CHIF budget income.

According to the proposed draft, in 2024, income of the CHIF budget will consist of:

  • CHI contributions, administered by SODRA – about EUR 2.4 billion;
  • State budget contributions for insured persons covered by state funds – more than EUR 898 billion;
  • State budget assignations for financing functions delegated by the state - over EUR 167 million;
  • other income – EUR 22.3 million.

“It is planned that, next year, 99% of CHIF budget income will consist of health insurance contributions and state budget assignations. All these funds will be used to pay for health care - personal health care services, medicines and medical aids, health programmes and other costs,” S. Adamkevičiūtė says.

Compared to this year, CHIF budget will increase spending on healthcare services by EUR 266 million (12.4%), with an increase of EUR 62 million (10.8%) for the reimbursement of medicines, medical aids, orthopaedic technical devices and rental of medical aids. An additional EUR 40 million (24.4%) will be spent on health programmes and other health insurance costs.

What will additional costs be used for?

Funds, allocated for paying for personal health care services, make the biggest part of expenses of CHIF budget – EUR 2.4 billion (about 70% of all expenses). Next year, it is planned to increase reference prices of health care services to enable health facilities to increase wages by at least 10%. EUR 178 million is planned. Additional EUR 128 million is also foreseen for the continuity of commitments, expansion of services and new services. 

In 2024-2026, it is foreseen to continue the development of cost-effective healthcare services, to increase the number of day surgery and day hospital services, and to launch new services reimbursed by the CHIF budget. The aim is to promote application of complex diagnostic and treatment methods in the outpatient practice and to reduce hospitalization. Also, procedure of payment for consultations of specialists will be further improved seeking to link the payment of health care services to their quality and efficiency. It is planned to differentiate consultations of specialists in several stages and to increase reference prices of higher-volume outpatient services.

In order to increase accessibility to primary outpatient personal health care, it is planned to gradually increase a family doctor’s team up to 2030 by engaging new team members and increasing the number of specialist posts in the family doctor’s team. It also plans to promote mental health centres for better care of people diagnosed with affective and/or neurotic disorders. Moreover, it is planned to develop mental day hospital services and introduce payments for new integrated community-based mental health services, which would be more patient-friendly and help patients to integrate into public life more quickly.

It is planned to reduce the number of residents served by oral hygienists as of 2024 for patients to receive services faster. It also aims to improve access to nursing services and to ensure the provision of outpatient nursing services at home outside working days. From the next year, there will be a charge for specialised transport and an increase in the reference price for supported medical rehabilitation services, given that these rehabilitation services are for people with disabilities and must include the services of an assistant.

EUR 634 million is to be spent next year on medicines, MAs (including orthopaedic technical devices) and rental of medical aids. In this area, in 2024, the aim will be to increase the number of already reimbursed MAs and to include new effective medicines and new tools in the reimbursement system. Also, to increase the share of reimbursed medicines, compared to all prescribed medicines, thus, ensuring reduction of patients’ costs for medicines. In addition, reimbursement of food purchase for special medical purposes for patients on enteral nutrition at home is planned to start from the next year. In the field of orthopaedic technical devices and medical devices, the aim is to start partial reimbursement of spectacle lenses for pre-school children diagnosed with visual impairment. It also foresees a recalculation of reference prices of some hearing aids, dental braces and orthodontic plates.

Substantial reserve

The CHIF reserve is projected to reach EUR 637 million by the beginning of 2024.

According to the projections of Lithuania’s economic indicators, CHIF budget, including balances, is expected to reach 5.4% of gross domestic product next year.

(Piktochart photo)

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Last updated: 24-10-2023

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