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22-02-2023

Medical institutions will be encouraged to provide more consultations with cardiologists, neurologists and oncologists

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Considering the high demand for some outpatient healthcare services, the Ministry of Health has taken action to increase access to them. The updated payment procedure will encourage healthcare institutions to increase the number of outpatient services, with a particular focus on consultations with doctors from priority specialties: cardiologists, neurologists, endocrinologists, haematologists, radiotherapy oncologists and chemotherapy oncologists.

The Minister of Health, Arūnas Dulkys, says the changes were made in response to data on waiting lists for some specialists. The decisions will speed up patients' access to doctors in the most needed specialties and reduce queues at medical institutions.

“We are taking measures to shorten the queues to see specialists: we have identified the main diseases that have the greatest impact on morbidity and mortality in Lithuania, and adjusted the procedure for payment of services so that people with these diseases can see doctors as soon as possible,” says the Minister of Health Arūnas Dulkys.

According to Gintaras Kacevičius, Director of the National Health Insurance Fund, the conclusion of contracts between the health insurance funds and medical institutions is currently underway, and “taking into account the provisions of the updated payment procedure, we will invite medical institutions to undertake in their contracts to provide more of the services for which the queues are the longest, and we will guarantee that, if necessary, we will allocate additional funds from the Compulsory Health Insurance Fund for this purpose.”

Priority consultations will be covered by a separate amount in the contracts between health care institutions and Territorial Health Insurance Fund (THIF) on the reimbursement of health care services from the Compulsory Health Insurance Fund (CHIF). If a health care institution does not use the full amount for priority services, the balance will not be used to pay for other services and will be used to pay for priority services exceeded by other health care institutions.

If a medical institution provides more priority services than contracted for, these services will be paid for on a priority basis using the unspent funds of other service groups at the end of the reporting period (month), at the end of the six-month period and at the end of the year.

Payment for outpatient services over and above the contract level will be made twice a year, instead of once. Unused funds can be reallocated between service groups within the same facility on a monthly basis. The limitation that until now allowed for a maximum of 25% of the value of over-contracted outpatient specialist consultations is also removed.

In order to increase the coverage of outpatient services and to improve their accessibility and reimbursement, indexation of inpatient services has been withdrawn. It is also foreseen to use funds planned but not used for inpatient services in health care institutions to pay for outpatient services.

The Order of the Minister of Health on the amendment to the procedure for payment of personal healthcare services can be found HERE.

The amendments are part of the Government's programme to improve the healthcare financing model, to improve access to services, and to link payment for services to their quality and efficiency.

(Piktochart photo)

The NHIF invites you:

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

Last updated: 06-03-2023

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