The goal of the project was to make the pricing of the health care services by the Health Insurance Fund (EHIF) transparent and justified. The project involved representatives of all major medical professions and medical institutions in order to reach an agreement on shared pricing principles, price components and costs.
Currently, nearly 80 % of the services financed by the EHIF are priced on the basis of the pricing model and any changes in the expenditures for various resources (e.g., medical workers’ salaries, capital costs) are made in compliance with the principles of the pricing model. Currently, the main project development activities still concern the description of services that have not yet been described using the ABC method and addition of these descriptions to the pricing model. The subsequent planned steps include:
Submission of input reports required for the pricing model easier for them
The primary precondition of such large-scale project requiring active contributions from different parties throughout the project period is the desire of all parties to reach the expected project results, i.e., different interest groups should see that they can benefit from the results of the project. The second lesson was that it is not practical to focus on small details (e.g., cost of individual medical supplies) at the system level, because they have limited influence on the general model and it could be too time-consuming to make them fully accurate.
|Award category:||scarce resources|
|Sector:||Public health and social welfare/affairs|
|Type of activity:||quality management|
|Keywords:||health insurance, pricing|
|Short English description:||redefining prices for medical services by the public health insurance fund|
|Organisation:||Estonian Health Insurance fund|
|Level of government:||national level|
|Size of organisation:|
|Number of people involved:|
|EU membership:||EU member|