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27-07-2023

The health insurance funds: patients receive more and more rehabilitation services

Iliustracija

Specialists of the National Health Insurance Fund (NHIF) under the Ministry of Health notice that the number of rehabilitation services provided to patients has increased significantly in recent years after the pandemic. What led to this and what services are needed most often?

According to NHIF calculations, 20% more outpatient medical services and 22% more psychosocial rehabilitation services were provided last year compared to the pre-pandemic year 2019. The number of provided primary outpatient medical rehabilitation services increases as well. 30 pct. more of these services was provided las year than in 2021. The number of inpatient medical rehabilitation services is also slowly increasing – it has almost reached the pre-pandemic level. Priority inpatient rehabilitation services are also on the rise, especially those which are provided after endoprosthesis.

“The increasing need for rehabilitation is due to the fact that residents have slowly returned to their postponed health issues after the pandemic and are more likely to visit specialists without fear of COVID-19 infection. Also, the increase in the number of rehabilitation services provided has also been influenced by the cancellation of limited referrals as of 2021. As a result, there is no longer a contractual amount for referrals to referring health care institutions, which means that residents can be provided with rehabilitation services more easily,” says R. Venclovienė, Advisor of the Services Management Division of the NHIF.

She said that the distribution of rehabilitation services varies from one institution to another, depending on the services that the institution has contracted with the national health funds. However, mostly primary outpatient and inpatient medical rehabilitation services are provided.

According to the data of the NHIF, in 2022, more than 400 thousand people received primary rehabilitation services, paid for by the CHIF, that amounted EUR 34 million. Meanwhile, reimbursed inpatient rehabilitation services amounted to almost EUR 56 million (more than 900 thousand bed-days), outpatient services – almost EUR 16 million, and psychosocial rehabilitation services amounted to just over EUR 1 million.

As demand for rehabilitation services grows, so does the funding for these services. In 2021, EUR 98 million was allocated to rehabilitation, last year – EUR 114 million and this year – EUR 120 million from the CHIF.

This year, additional funds are being allocated to cover the growing need for primary and outpatient medical and psychosocial rehabilitation services, and ensuring that patients have access to rehabilitation services closer to home. It is also planned to cover all priority inpatient rehabilitation services this year. 

The health insurance funds remind that from 2022 onwards, there is a distinct group of priority inpatient medical rehabilitation services, for which a separate contractual amount is foreseen and the possibility to pay for over-contracted services on a monthly basis from the CHIF is provided. This group includes patients after acute illnesses that disrupt biosocial functions, such as heart attack, stroke, injuries, endoprosthetic surgeries, treatment of some oncological diseases, as well as children and patients with extremely serious medical conditions who require level III inpatient rehabilitation. This ensures that rehabilitation is made available first to those patients, who need mostly to receive these services timely.

For other groups of rehabilitation services, over-contract payment is foreseen after the end of a calendar year, according to the possibilities of the CHIF, and part of over-contract services of primary outpatient, outpatient and psychosocial rehabilitation is also paid after the end of the first half of the year. Over-contract services are paid on a priority basis, with the outpatient medical and psychosocial rehabilitation services being paid first. The aim is to promote the provision of outpatient services.

(Freepik photo)

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Last updated: 21-08-2023

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