Filenews 28 May 2022 - by Marilena Panagi
Ready to implement the new way of remuneration of personal doctors of the GHS on June 1, the Health Insurance Organization states, but the scientific societies representing the doctors probably do not agree since they question the timetable, claim that they have not reached any agreement and are waiting in writing for the Agency's proposal to study it and also take a position in writing when they are ready.
The amounts that the doctors will receive under the new design were approved by the Board of Directors of the Organization at Thursday's meeting and based on the relevant proposal, the doctors will be given an additional amount to cover the on-call services they will offer to the GHS, if and when of course the HIO manages to put the on-call clinics into operation.
The GHS's design provides that as of June 1, 2022, personal doctors for adults and children will receive 80% of their remuneration as per capita income depending on the number of beneficiaries registered in their list and the remaining 20% on the basis of performance indicators and quality criteria.
The list of performance indicators and qualitative criteria will be implemented with the weight of each indicator / criterion being such (in the first phase) that 20% is covered. Then, when the HIO has in its hands the recommendations of the experts who have undertaken the elaboration of a relevant study, the list will be enriched and the severities per indicator / criterion will be changed with the aim of differentiating the ratio to 30% - 70%.
According to the plan approved on Thursday by the HIO, as of June 1, 2022:
Paediatricians as per capita income will receive:
>> For children from 0-3 years old, €185 (compared to €210 received so far).
>> For children 4-9 years old €137 (compared to €155 received so far).
>> For children 10-18 years old €80 (compared to €91 received until now).
As regards other criteria:
>> Paediatricians will be paid on the basis of a fixed price of €250 for each birth and newborn care until discharge with a maximum period of stay of the newborn in the hospital of 72 hours.
>> Also, they will be paid per incident on the basis of a fixed price for the evacuation by ambulance to a hospital in case this is deemed necessary after childbirth with the amounts being €100 for evacuation within the same province and €300 for evacuation from one province to another.
>> With €20, paediatricians will also be paid for each visit to a permanently overcrowded beneficiary. (The maximum number of visits per beneficiary is 6 per calendar year).
The total amount of the global budget for the period from June 1st to December 31st, 2022 is €1,467,000.
Regarding the on-call services that paediatricians will offer with the start of operation of the on-call clinics, the HIO's design provides for a fee of €55 per hour. In the case of on-call time, the allocation will be additional to the budget for paediatricians.
What personal doctors will receive for adults
Personal doctors for adults will receive as per capita income:
>> For beneficiaries aged 15-18 at €80 (compared to €91 received until today).
>> For beneficiaries aged 19-51 €66 (compared to €83 received so far).
>> For beneficiaries aged 52-71 €93 (compared to €117 received until today).
>> For beneficiaries aged 72 and over €115 (compared to €145 received until today).
In addition, doctors will receive €20 per visit to an inclined beneficiary (home care) with a maximum number of visits per beneficiary, 6 per year.
Among the performance indicators of personal doctors for adults have included:
>> The number of referrals to a specialist doctor.
>> The number of referrals for diagnostic tests.
>> The number of referrals for laboratory tests.
The amounts and percentages per indicator will be finalized in the coming days.
The total amount of the global budget for the period from 1 June to 31 December 2022 is €7,583,000.
Regarding the on-call services that will be offered by personal doctors for adults with the start of operation of the on-call clinics, the HIO's design provides for a fee of €55 per hour. In the case of on-call time, the budget allocated will be in addition to the budget for personal doctors.
Doctors didn't say the last word
The personal doctors of the GHS, in contrast to the HIO, express their reservations about whether the new way of their remuneration can be applied from June 1st, since they themselves have not yet finally taken a position on the proposals put before them by the Organization.
In statements on state radio, the president of the Scientific Society of Family Doctors, Andreas Polyneikis, said that "we do not see that we are ready for June 1st. We are still in consultation with the HIO. We have said that they will send us some clarifications in writing and the details needed on various issues concerning the criteria and indicators in order for us to be able to respond. I don't think this will be done to catch up with June 1."
Asked about whether doctors have an objection to the definition of performance indicators with regard to referrals issued by personal doctors, Mr. Polynices argued that "an objection cannot be said to exist but the problem is that the Cypriot has been accustomed for decades, waking up in the morning, hurting his eye and going to the ophthalmologist and now many times we are taken patients from the clinics of colleagues and they tell us to issue a referral at that time. People need to be educated on this issue." In addition, he said, "we want to be given clarifications in relation to the referrals of chronic patients, etc. We still don't have that."
From the point of view of the HIO, there seems to be a different view since in his statements the Director of the Organization, Andreas Papakonstantinou, mentioned that the Organization is ready and on June 1st the new way of remuneration of doctors will be implemented normally.
Both made it clear in their statements that the renewal of the personal doctors' contracts, which has been completed, is not linked to the change in the way of remuneration.
