The Price Setting in Public Sector - the Example of Estonian Health Insurance Fund

From EPSA - European Public Sector Award


Short description of the project

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.

Current status and future steps for the project

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:

  1. Making the technical solution of the pricing model more user-friendly and flexible;
  2. Supporting the development of cost accounting systems in the providers’ institutions to make

Submission of input reports required for the pricing model easier for them

Lessons learned

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 info
Award category: scarce resources
Award type: submission
Award year: 2007
Project type
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
Further information
Organisation: Estonian Health Insurance fund
Other applicants:
Level of government: national level
Size of organisation:
Number of people involved:
Country: Estonia
EU membership: EU member
Language code: en
Start date: 2003/06/01
End date:

The Price Setting in Public Sector - the Example of Estonian Health Insurance Fund (59.430788° N, 24.755355° E)
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