Filenews 25 February 2022 - by Marilena Panagi
The participation of personal doctors for adults and children in the on-call program prepared by the HIO is mandatory, while the new compensation plan for doctors includes the home service of bedridden patients.
As of June 1st, the HIO is preparing to implement two important new projects in the GHS and to this end, it has already scheduled meetings with the doctors themselves in order to present its proposals and proceed to a dialogue so that all the necessary preparation can take place in time and there are no outstanding issues that may endanger the set timetables.
Next Thursday, the HIO will have a meeting with representatives of paediatricians, while as we are informed with representatives of personal doctors for adults, relevant meetings have been held in the past and will surely follow more.
The simultaneous implementation of the two new HIO plans is considered necessary since, on the one hand, the new compensation plan for personal doctors must be implemented on June 1st, the date on which all doctors' contracts are renewed and on the other hand, this includes the mandatory nature of the doctors' participation in the on-call program (which will also be part of their remuneration) and will be implemented by the HIO within the framework of the a second programme concerning the operation of on-call clinics and paediatric clinics.
With regard to the plan to change the way of remuneration of personal doctors of the GHS, information provided by "F" indicates that this was drawn up on the basis of the initial design of the System, on the basis of which personal doctors for adults and paediatricians receive 70% of their remuneration as per capita income, i.e. depending on the number of beneficiaries who have registered in their list and the remaining 30% on the basis of specific ones, indicators, operations and criteria.
In the first phase, as we are informed, the HIO may not proceed to the full implementation of the design but will implement the plan with differentiated proportions depending on where any consultations with those directly affected will end up. The Agency's constant goal in the full implementation of the design, the percentages to stabilize in the initial design.
The Board of Directors of the Organization had studied the plan prepared by the competent management of the HIO since the beginning of January, and therefore, only the finalization of the details remains now, which will be achieved to a significant extent after the consultation that is expected to follow with the doctors themselves.
The HIO's proposal
In detail, the proposal prepared by the HIO includes quality criteria for specific services as well as performance criteria.
For personal doctors, the percentage to be determined (30% or 20%) will include (depending on the percentage may some of the criteria set, to be deducted in the first phase of the implementation of the Plan):
For personal doctors for adults
- Fee per service
>> Management of chronic diseases (e.g. type 2 diabetes mellitus).
>> Criteria for the management of additional chronic diseases (e.g. hypertension).
>> Home visits to permanently inclined beneficiaries.
>> Administration of injectable treatment.
>> Administration of intravenous fluids.
>> Vaccination of adults, in the context of promoting the Adult Vaccination Scheme of the Ministry of Health.
>> Staffing of a clinic with nursing staff.
>> Staffing of a clinic with support staff.
>> Provision of on-call services (participation in on-call duty will be compulsory or with the appointment of a replacement; i.e. doctors will have the right not to be present at the on-call centre to be called upon, but they will be obliged to appoint a colleague to carry out their on-call duty).
For paediatricians:
- Fee per service
>> Management of chronic diseases.
>> Obesity Management.
>> Criteria for the management of chronic diseases.
>> Promotion of preventive controls based on protocols of the Paediatric Society (e.g. preventive ophthalmological examination, screening for developmental power biplasia, dyslipidemia control, etc.).
>> Presentation in childbirth and care of a newborn until discharge, with a maximum referral period to the hospital of 48 hours.
>> Home visits to permanently inclined patients.
>> Injectable treatment.
>> Vaccination.
>> Staffing of a clinic with nursing staff.
>> Staffing of a clinic with support staff.
>> Provision of on-call services (participation in on-call duty will be mandatory or with the appointment of a replacement).
For all personal doctors
For all personal doctors (adults and children), fees are additionally set based on performance indicators. These indicators, based on the proposed plan, include:
>> Referrals to specialist doctors.
>> References for laboratory tests.
>> Referrals for radiodiagnostic examinations.
The process of defining quality criteria is underway
The specific HIO Plan is expected to enter into force on June 1, 2022, however, it must be assumed that their provisions and the criteria on the basis of which the GHS's personal doctors will be remunerated will be differentiated according to the needs or data that will arise. Moreover, the Contract signed by the HIO with a specialized Firm, for the development of quality-based compensation models for both primary and intra-party health care, is also in force. This project is funded by the EU and is included in the recovery and resilience plan of Cyprus.
In addition, for the implementation of the Plan, adjustments are also imposed on the GHS's IT system, while the HIO, with the finalization of the actions to be implemented in the first phase, will proceed to a final determination of the budget that will be transferred for the compensation of doctors based on criteria.
Consultation is required for on-call clinics
The HIO's efforts to operate on-call clinics had begun immediately after the implementation of the System in 2019. However, all the efforts made fell on deaf ears, mainly due to the reluctance of doctors or clinicians to participate. At the same time, an effort had been made through the CSO, also without a conclusion since in the meantime the pandemic occurred and all relevant consultations were suspended.
At this moment, as we are informed, and according to what was discussed last Tuesday between the Minister of Health and the HIO, an effort will be made so that the Health Insurance Organisation will ensure (at the necessary price) the various structures of the CySEC which will be used during non-working hours and days as on-call GHS clinics.
The new consultation should start in the next few weeks as the two Organizations have at their disposal a little more than 3 months before the timetable of June 1st that has been set.
