22-06-2021

Lithuanian health care: main fact and numbers of 2020

The rhythm and peculiarities of the activities of the health insurance fund, similarly to the entire health care system, were determined by the coronavirus infection in 2020. The quarantine dictated the specific care conditions and payment for work. Despite of objective difficulties, the health insurance fund managed to ensure normal sustainability and financial vitality of the health sector.

In 2020, the budget of the Compulsory Health Insurance Fund (CHIF) received 2.2 billion euro – 107 million euro less than planned, i.e., the revenue plan was implemented by 95 percent. Smaller revenues were determined by increased unemployment level in 2020 and the decision to postpone the payment of compulsory health insurance for self-employed persons. However, despite of the circumstances, the dynamics of CHIF budget remained stable: the income of last year was 8.5 percent higher than in 2019, while the calculated receivable income of CHIF budget amounted to almost 2.3 billion euro.

The net expenses of CHIF budget in 2020 according to the undertaken obligations amounted to 2.2 billion euro – the plan was implemented by 96 percent. The main part of the CHIF budget’s expenses consisted of the funds assigned for payment of personal health care services(1.6 billion euro).

In 2020, the factual reserve of the CHIF budget amounted to 434 million euro. The big importance of this reserve became evident in 2020 exactly. The major portion of the reserve (130 million euro) was used to pay personal health care services with increase values of basic price score, hence, creating conditions for increase in the wages of employees of medical institutions. The values of basic price score were increased by 9-12 percent on average. Another important portion of the reserve – 34.6 million euro – was used to compensate the expenses of the medical institutions caused by increase in the wages of the employees taking care about Covid-19 patients under the Law on Prevention and Control of Human Communicable Diseases. It should be noted that almost 25 million euro from the reserve were used to compensate the drugs from the reserve list.

The application of payment principles adjusted to Covid circumstances and additional funds from the CHIF budget helped the medical institutions to preserve their financial stability – the general outcome of the annual financial activities of public institutions was positive. By the way, the National Health Insurance Fund under the Ministry of Health (NHIF) assured urgent payment of the invoices submitted by 5 main personal health care institutions providing Covid-19 services and ambulance stations during the entire quarantine period.

In order to ensure accessibility of personal health care services and financial stability of the medical institution, NHIF was assessing the status of contract execution by the territorial health insurance funds and medical institutions and the dynamics of provision of personal health care services all the time and was forwarding that information to the Ministry of Health. The latter was improving continuously the principles of provision and payment of health care services (mainly outpatient, inpatient, and inpatient nursing) all year long. Since 2020, certain restrictions have been applied on service provision. The priority was given to treatment of coronavirus patients all year long, and the necessary aid was never interrupted.

The quarantine also forced to search for unusual forms to provide health care services and legalise payment for them. General practitioners and specialist doctors started to provide online consultations actively last year. An individual basic price was fixed for online consultations of specialist doctors.

Besides, the scope of day inpatient services for adults was expanded in 2020: it is possible to restore the cardiac rhythm here, to apply intravenous biological and alternative ferment therapy, to perform endofibroscopic procedures, by applying general anaesthesia, etc.

The need for funds for compensated drugs and medical aids has been growing not only because of aging population but also because of necessity to compensate the new drugs with high therapeutic value. In 2020, the additional compensation of drugs of 36 generic names was started – 10 more than last year. These are drugs for HIV, migraine, disseminated sclerosis, oncologic diseases, diabetes mellitus type II, dermal diseases, and many other diseases. It should be noted that on 01 July 2020, the possibility was created for the groups of the most vulnerable residents, i.e., 75-year-old and older patients, persons over 65 years old with small income, and persons with disabilities, to receive the compensated drugs and medical aids without paying the patient’s surcharge. 6.8 million euro were spent for this purpose in 2020. In total, in 2020, 348 million euro from the CHIF budget were spent on the compensated drugs and medical aids (including the money used to compensate the surcharges).

Last year, the health insurance fund managed to solve the problem of the decade – as the financing was increased significantly, no queue for dental prosthesis remained in the 4th quarter of the year. This prosthesis services may be received almost immediately since this January. 39.2 million euro from the CHIF budget were attributed to compensate the expenses of dental prosthesis in 2020; well, due to Covid-19, not all these funds were used.

According to the NHIF data, there are more than 1.5 million people in Lithuania at present, who are entitled to the services provided in the preventive programmes, according to the age: i.e., to carry out free tests of cancer of cervix uteri, breast, large intestine and prostate, cardiovascular diseases. 23.7 million euro were planned in the CHIF budget for these programmes last year. However, the residents were afraid of coronavirus infections and thus, they avoided coming to the medical institutions for examination. Still, the data of this year are optimistic – the patients have resumed active participation in these programmes.

The Council of the Compulsory Health Insurance approved the reports on execution of the CHIF budget of 2020. The documents will be also considered by the Government and the Seimas (Parliament).

The NHIF invites you:

Your questions are welcome by email [email protected] or phone: local (8 5) 232 2222, international +370 5 232 2222.