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14-02-2023

The health insurance funds: contracts with partners will be signed much earlier this year

Iliustracija

This year, the process of concluding contracts between the health insurance funds and medical institutions began much earlier. All contracts are expected to be concluded before the beginning of March. On average, 11% more money will be allocated per year to finance personal healthcare services, informs the National Health Insurance Fund under the Ministry of Health (NHIF).  

“We were able to start signing contracts with partners almost two months earlier this year than last year. Now the process is in full swing. According to the latest data, the Territorial Health Insurance Funds have already concluded contracts with 359 out of the planned 874 medical institutions”, says Gintaras Kacevičius, Director of the NHIF.  

For the third year running, medical institutions have signed only one contract with the Territorial Health Insurance Fund (THIF) in which the institution's headquarters are located. The contract concludes for the provision of services to the entire population of Lithuania paid for by the Compulsory Health Insurance Fund (CHIF). The exception is primary outpatient health care and outpatient nursing services, for which contracts are signed with the THIF in whose area the services are provided.

According to G. Kacevičius, the implementation of the single contract principle by the health insurance funds has not only reduced the administrative burden on healthcare institutions, but also significantly expanded the choice of healthcare institutions for patients.  

This year, EUR 391 million is planned to be allocated from the CHIF for primary outpatient healthcare. This is EUR 28 million more than at the beginning of last year. The increased funding is expected to ensure the development of the family doctor team, as well as to broaden the competences of the family doctor, allowing him/her to carry out a wider range of examinations.  
Almost EUR 50 million is allocated to ambulance services for half of the year, which is EUR 5 million more than in the first half of last year (additional funds will be made available for the second half of the year, following the restructuring of the ambulance service).

Almost EUR 1.5 billion of CHIF is planned to be provided for doctors' consultations, day hospitals, day surgery and other outpatient services, as well as nursing and inpatient services. This is EUR 154 million more than last year. The increase in funding and improvements in financing methods will focus on making services more accessible, which have not yet fully recovered from the pandemic.  

For example, this year's contracts foresee priority consultations with specialists - those whose availability is related to the diseases that have the greatest impact on morbidity and mortality in Lithuania. Therefore, it is planned to increase the amount of the CHIF to cover the services of cardiologists, neurologists, haematologists, oncology chemotherapists, oncology radiotherapists and endocrinologists for all the patients this year. This change is expected to make these consultations more accessible to patients, reduce queues and provide a financial basis for the operation of “green corridors”, allowing patients with more serious illnesses to receive services more quickly without waiting in a general queue.  

In addition, this year, prices for consultations where a patient undergoes several procedures are set to increase, thus encouraging healthcare institutions to provide more services per visit, while reducing the need for hospitalisation.

This year, almost 13% more funding - EUR 120 million in total - will be allocated to cover medical rehabilitation and sanatorium treatment. The additional funds will cover the growing need for primary and outpatient medical and psychosocial rehabilitation services and ensure that patients can access rehabilitation services closer to home. It is also planned to pay for all priority inpatient rehabilitation services this year, i.e., those that need to be provided immediately - after heart attacks, strokes, trauma, endoprosthetic surgery, surgery for many oncologic diseases, etc. The aim is to improve the availability of these services in the country's medical institutions.

Moreover, EUR 34 million are foreseen for five preventive health programmes. This is 12% (EUR 4 million) more than last year. The increased funding will not only help to ensure the efficient running of the programmes, but also to make the cardiovascular disease prevention programme more effective. This year's programme will include innovations that will allow more people at highest risk of cardiological diseases to be screened.

The NHIF notes that last year THIFs signed contracts with 860 medical institutions, 618 of which were public and 242 private institutions and their branches. All health care institutions that have concluded contracts with the health insurance funds and the services they provide throughout Lithuania can be conveniently found in an interactive search engine created by the specialists of the health insurance funds.  

(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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