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12-09-2024

Health insurance funds: payment of services exceeding the terms of the contract improved finances of treatment facilities

Iliustracija

The financial situation of Lithuanian medical institutions has significantly improved after the health insurance funds paid EUR 94 million to Lithuanian medical institutions for services, which exceeded the terms of the contract and were provided to patients during the first half of this year. Currently, the overall financial result of all public healthcare institutions in terms of the use of the Compulsory Health Insurance Fund is positive and makes EUR 4 million.

“In the first half of this year, revenues of public healthcare institutions from the Compulsory Health Insurance Fund (CHIF) grew rapidly by 13%, but costs grew slightly more, by 15%, which affected the final financial result. If the costs had risen at the same rate as revenues, the positive financial result for healthcare institutions would have been even higher. However, we can be pleased that the proportion of public healthcare institutions with a positive financial result is higher than in the same period a year ago,” Simona Adamkevičiūtė, director of the Economics Department of the National Health Insurance Fund under the Ministry of Health, says.

According to her, 125 healthcare institutions ended the first half of the year with a positive financial result, while 51 ended the first half with a negative one.

Based on the data of the NHIF, four groups of healthcare facilities – district, nursing and palliative care hospitals, polyclinics and primary health care centres – have a positive aggregate financial result.

Although the overall financial result of the University Hospitals is negative and reaches at almost EUR -3 million, most of them are performing well or improving. The negative aggregate financial result of the University Hospitals is due to the result of Klaipėda University Hospital (EUR -5.3 million).

The majority of hospitals at republican level have positive or slightly negative financial results. Their combined result is close to -1.7 million euro. Similarly, the group of hospitals in the region has a negative overall financial result of less than one million euro.

“The overall financial situation of Lithuanian healthcare institutions is good and sustainable after the payment of services exceeding the terms of the contract, whereas the negative financial performance of individual healthcare institutions is due to very different reasons,” S. Adamkevičiūtė emphasizes.

The NHIF reminds that in the first half of this year, Lithuanian medical institutions provided a record number of medical consultations – significantly more than the number of consultations provided for in the agreements between medical institutions and territorial health insurance funds. During the first half of the year, services exceeding the terms of the contract, amounting to almost EUR 94 million, were provided. The budget of the Compulsory Health Insurance Fund alone was not sufficient to pay for services exceeding the terms of the contract, so part of healthcare services exceeding the terms of the contract were paid for by this budget (EUR 27 million) and the rest by the reserve funds (EUR 67 million).

(Piktochart photo)

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Last updated: 01-10-2024

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