Filenews 25 August 2023 - by Marilena Panayi
September is the month of changes for the General Health System. The Health Insurance Organisation is ready to implement several of the decisions and plans taken or drawn up in the previous months and the procedures are currently in their final stages.
The inclusion in the GHS of private Accident and Emergency Departments is perhaps the most important change in terms of patient service, followed by a change in the opening hours of on-call clinics.
In addition, in September, new hospitals will be included in the GHS, the way hospitals in the system are generally compensated will change, while quality criteria will be implemented which, from September onwards, will begin to be taken into account when calculating the remuneration of personal doctors.
Regarding the integration of TAEP into the GHS, the director of the HIO, Andreas Papaconstantinou, told "F" that, "the first TAEP will be available to the beneficiaries of the system from September 25, the date on which the polyclinic "Hygeia" based in Limassol will join the GHS.
As far as Nicosia is concerned, "the Apollonion Hospital will be somewhat delayed in joining the GHS due to the work carried out at the hospital. That's why the date has been pushed back to October 1." This hospital, Mr. Papaconstantinou said, "has remodeled its facilities in order to offer full emergency services to GHS beneficiaries. It looks like it takes a few more weeks to complete the work that is underway."
With the inclusion of these two TAEP in the GHS, the HIO will intensify its efforts and consultations for the inclusion of two more departments in the system, "with the aim of covering the districts of Larnaka and Pafos as well". Regarding Pafos, he said, "we have already started the dialogue with one of our hospitals which has an ICU, we still have some pending issues but I believe that in the coming period and after intensifying the dialogue we will reach an agreement."
Mr. Papaconstantinouclarified that "the compensation of hospitals in terms of TAEP services is the same in any case, since the organization's requirements are the same."
For on-call clinics, the change in their opening hours will take effect from September 1. A detailed operating plan has already been sent to the doctors who will staff the clinics. Under the new plan, the hours of on-call clinics from September 1 will be reduced by two hours on Saturday and extended by two hours on Sundays and holidays.
Therefore, the on-call clinics will operate both on weekends and holidays from 11 a.m. to 5 p.m. The new opening hours of the GHS on-call clinics, Mr. Papaconstantinou said, "was drawn up after studying and processing the data concerning traffic throughout the previous year. In other words, the new working hours were adapted to the needs that, as it was established by the processing of the data, the beneficiaries of the GHS have".
It is expected that the new way of compensating the hospitals of the system will be implemented in September. Most hospitals have already signed their new contracts with the HIO, while others have scheduled their visit to the organization for the next few days. Among them, the large hospitals of Nicosia (yesterday one of the major hospitals of Limassol signed a new contract).
The signing of the new contracts by some hospitals that are members of the Pancyprian Association of Private Hospitals is pending, which has officially informed the HIO that it still disagrees with some of the provisions of the new compensation scheme for hospitals. "As far as some hospitals are concerned, we still have some outstanding issues, but we must say that the HIO, at least as far as the financial part is concerned, has included in its planning the maximum levels that the relevant budget can reach," Papaconstantinou said.
"After several months of consultations and many changes we have made in order to satisfy our hospitals, we feel that there is no room for further design changes at this time. We have also mentioned this in a response we prepared for PASIN and we expect that there will be goodwill and cooperation on their part to start implementing the new way of compensation and certainly if some distortions are identified along the way, we will be here to discuss and find solutions," he added.
It is recalled that one of PASIN's main demands was the deletion of the provision concerning the granting of a 10% increase in the compensation of hospitals of the State Health Services Organization. The HIO satisfied this request of the private sector by deciding to delete this provision from its planning and to conclude a different agreement with the public hospitals, however, this action subsequently provoked a strong protest by the SHSO.
It is also reported that the dialogue between the HIO and hospitals on the new way of compensation had begun in autumn 2022 and after several disagreements and delays intensified last spring.
Prevention programs for personal doctors
The HIO's planning regarding the way in which GHS personal doctors who will receive 20% of their compensation will be paid from now on will be implemented with the new month, only if they manage to achieve the quality criteria that have been set.
The remaining 80% will continue to be paid to them as per capita income, i.e. depending on the number and age of beneficiaries registered on their list.
From September, the criterion related to the participation of doctors in training seminars will be applied. In addition, doctors will be able to increase their income if they screen all their beneficiaries over the age of 45 for blood pressure.
The aim of the HIO is to start recording official statistical data for Cyprus in this way. The criterion concerning influenza vaccination for beneficiaries over 65 years old will also be implemented, while the amount doctors receive for home visits will be increased from €20 today to €30 per visit.
The planning for the new way of remuneration of personal doctors includes other performance indicators and quality criteria that will be implemented during October and November.
Background
The coverage of the cost of Services of General Economic Interest, which are offered exclusively by the Cyprus Public Health Organization, is the main topic of discussion among those involved behind the scenes.
The SHSO has already priced these services, while the Presidential Council has ordered that they be separated and that the Ministry of Health and the HIO assume their share of them. The problem is that in the SHSO, they had taken it for granted that the HIO, through the new way of compensating GHS hospitals, would give the agreed additional 10% to the compensation of public hospitals, which is no longer the case.
Over the past two weeks, the backstage between representatives of the two organizations has been intense and, as everything shows, it will continue.
