Referrals for laboratory tests are coming under close monitoring, with the Health Insurance Organization piloting a special "indicator" of doctors' control, in order to identify the exact cause of the significant increase in patient referrals recorded on a continuous basis in recent years.
Doctors of ten different medical specialties (haematology, gastroenterology, gynaecology-obstetrics, endocrinology, cardiology, neurology, nephrology, pathological oncology, pathology and rheumatology) have already received information about this, and the referrals for laboratory tests that will be registered by the end of June will pass through the sieve of the Organization.
Specifically, and according to the relevant announcement/briefing of doctors by the HIO, "the rationale for the introduction of the performance index is based on the fact that, in recent years, the number of laboratory tests has been constantly increasing, which does not seem to be justified by analyzing the epidemiological picture of the population and results in a burden on the total volume of laboratory tests, and, by extension, to burden the budget of the System". The goal, the Organization states, "is to streamline requests for laboratory tests."
In practice, the performance indicator will be based on the number of laboratory units resulting from each doctor's referrals, in relation to the total number of patient visits received by the specific doctor, with the aim of recording the "intensity" of the use of tests in daily clinical practice. The evaluation will be carried out quarterly and for each specialty, depending on its particularities, a reference point (maximum) is determined, which is calculated on the basis of the average and the standard practice of the specific specialty each month. Doctors who are below the benchmark will be considered to achieve the index, while those who show significant deviations will be identified for further evaluation.
An important element in the new process is that the pilot implementation will not be linked to financial consequences or doctors' reimbursements. On the contrary, the HIO clarifies that it is a monitoring and feedback tool, which mainly aims to raise awareness and inform the doctors themselves who will receive the relevant data through the monthly "GHS Services Use Statement", where both the reference point of their specialty and their personal performance will be presented. The first update is expected in June 2026. The measure, says the HIO, "does not aim to intervene in the medical crisis nor to limit the professional autonomy of doctors".
The index "is applied by specialty and the comparison is made exclusively between doctors of the same specialty, ensuring comparability and objective evaluation of the data". In addition, it is clarified that "the Organization in no way prohibits or restricts in any way the issuance of laboratory tests where and where it is deemed medically necessary".
The performance indicator "will be piloted for the period April – June 2026, without any connection with the reimbursement of specialist doctors". The pilot phase, according to the HIO, "aims to familiarize doctors with the tool, to monitor its functionality in practice and to collect data that will allow its further evaluation". During the pilot phase, the Organization "will continue, in collaboration with the scientific societies, to monitor and evaluate the results of each specialty and, where necessary, to make adjustments and corrective actions".
