As of today, Thursday, June 1st, on the 3rd anniversary of the General Health System’s operation, the method of payment of Personal Doctors and Pediatricians is changing, with the introduction of extra services, quality criteria and performance indicators, Director of Health Insurance Oragnisation (HIO), Efi Kammitsi told CNA on Wednesday.
The change will be gradual, she said, with the introduction of limited services and indicators, in order to be enriched during the year with additional quality criteria. From today, the remuneration of personal doctors will consist of 80% of per capita income, depending on how many beneficiaries they have registered, and 20% of performance indicators and other services, with the aim of gradually changing the ratio to 70% – 30% .
From today, 20% of the remuneration for adults’ personal doctors will come from a new service: home visits to permanently bedridden beneficiaries. Beneficiaries “who are registered by the doctors themselves in the system as permanently bedridden, will be able to be visited by doctors at home and the doctors will be reimbursed by the HIO for this home visit. There is a limit of 6 visits per year to each beneficiary. “Because we start from June until December, it will be 4 visits for the first year”, Kammitsi clarified, noting that if they see that more visits are needed, the number will change.
In addition, three performance indicators are applied, which measure the behaviour of doctors each month, in relation to the issuance of referrals to specialist doctors, for radiological examinations and for laboratory tests. These performance indicators will compare the average number of referrals issued by all physicians and 90% of physicians with the most correct behaviour will be paid, she said. The rest 10%, who has very high referral numbers will not receive compensation. Therefore, most doctors will be able to receive this, she said.
As far as paediatricians are concerned, 80% -20% is reintroduced in the ratio of per capita remuneration to criteria and new services, as well. In addition to home visits, pediatricians have an additional extra service of accompanying a child to the ambulance for transportation to a hospital. According to Kammitsi, this is a service that the doctors already provided, but were not paid for.
Regarding performance indicators for paediatricians’ behaviour, only the indicator for referrals to specialists is introduced, not for radiodiagnostic and laboratory tests. She noted that paediatricians do not have high referral rates for these issues, and referrals to specialists are much lower than adults’ personal doctors, but higher than European averages.
As of today, some new drugs are also added, while the checks towards all the providers are intensified, in order to deal with incidents of system abuse, while referral protocols are drawn up for the personal doctors to behave in a consistent manner.
Source: Cyprus News Agency