Video: Minister’s statement after a meeting with hospital management at the tertiary level
Valentina Prevolnik Rupel: ZZZS must update billing models on an ongoing basis
The Minister of Health, Valentina Prevolnik Rupel, is at a separate event, a meeting with the General Assembly of the Institute for Health Insurance (ZZZS), presented the plans of the ministry. She estimated that many services are not properly evaluated and do not follow actual costs. The minister emphasized that ZZZS must remain autonomous, but to a greater extent it must become active or a strategic buyer of healthcare services, which she says also includes realigning billing models to keep pace with actual costs.
As she estimated, billing models are now being renewed too slowly both at the specialist level and at the primary level, which leads to the fact that some services are underpriced and some are overpriced. If, through changes in laws and by-laws, the ministry can contribute to ZZZS performing the role of an active buyer better and more efficiently, they will do so, and they are also open to all suggestions, explained the minister.
Also, according to her predictions, the change in legislation will go in the direction of enabling the institution to carry out professional and financial supervision. ZZZS currently has limited options for supervising contractors, as it can only check whether the service is billed correctly. However, the wish is to have the opportunity to have a professional opinion on whether all the services were also professionally justified. According to Valentina Prevolnik Rupel, they did a test and found that there are tenfold differences in the performers. Since these were simple medical conditions, this difference cannot be the result of different professional guidelines.
The problem of unidentified patients
In terms of access to health services, Valentina Prevolnik Rupel highlighted the issue of unidentified patients, where a survey by municipalities with general medicine specialists found that this problem only exists in 15 municipalities, and thus it must be addressed according to the area where they are unidentified. Also, according to her, the number of undetermined people is increasing because the number of insured persons is growing rapidly. They are still trying to figure out why this is so.
More money is not the answer to waiting times
As for waiting times, which also affect accessibility, it has been shown that the solution is not only in increasing funds, the minister pointed out. As she stated, waiting times were shortened for interventions that are final, and even longer for services where the treatment is not final. Therefore, as the minister emphasized, it is necessary to find other ways. They prepared a waiting list management protocol, which was presented to the directors of health centers and hospitals at the secondary level on Monday, and today to the directors of hospitals at the tertiary level. The protocol will then be put up for public discussion, and solutions will have to be derived by amending the law on patient rights and regulations on waiting times.
Otherwise, as she said, the minister would like the stakeholders in health care to come to an agreement among themselves, clear up open issues and chart a course, as well as for the matter to be commented on in the media “in a slightly less aggressive way”. She did not want to comment on past matters. “I wouldn’t go back to history, what was, what was, I want to settle matters from now on,” she explained.
Members of the assembly satisfied with the visit
The members of the assembly emphasized that they themselves want constructive cooperation with the ministry. They see the fact that the minister responded to their invitation and came to the assembly today as a positive sign. As the general director of ZZZS said Tatjana Mlakar, “lately, a slightly warmer wind blows from Štefanova”.
Otherwise, the members of the assembly mostly evaluated the presented priorities as a step in the right direction, but they had many questions for the minister. They were interested in what was going on with the preparation of the ZZZS law, how the sustainability of the financing of the health care system would be ensured, and the related issue of the basket of rights. The minister was also asked about the mandatory health contribution, concessions, personnel standards in health care, management of health care institutions, consents for doctors in public institutions to work for other employers.
Valentina Prevolnik Rupel explained that the ministry is currently thinking that perhaps a new law on ZZZS would not be adopted at all, but that the amendment to the law on health care and health insurance would enable the aforementioned two necessary changes, so that the institute is an active buyer and to be able to perform financial and professional controls. At the same time, the minister also emphasized that she herself never spoke about canceling the general assembly of ZZZS.
She agreed that there are reservations in the management of public health institutions. Regarding the conclusion of undertaking contracts, he advocates, “not to ban, but to motivate employees where possible”. If it is not possible to find a solution in this way, the health policy will have to be adjusted accordingly, but the minister is of the opinion that the existing situation is not acceptable. According to her, the introduction of a competition clause is one of the solutions that she considers suitable, but certain conditions must be met. And measuring the effective workload of employees is, in her opinion, the first step in this direction.
As far as funding is concerned, if necessary, they will negotiate on the fly every year. The rights baskets are not touched for the time being, but if they are, it will have to be addressed in some kind of broad consensus, she further explained.