Will there be less teleportation? The National Health Fund introduces changes

For diagnosing and treating patients directly in the GP surgery, clinics will receive a higher salary – reminds the National Health Fund. On Friday, June 25, an amendment to the ordinance of the President of the National Health Fund in this matter entered into force.

Patients complaining about teleporces?

The National Health Fund amended the ordinance on the terms and implementation of contracts in the Primary Healthcare. Healthcare clinics that will treat and diagnose patients on the spot, in direct contact with a doctor, will receive a higher rate. The ordinance entered into force on Friday, June 25, but some of the provisions will apply from September 1.

In the press release, the National Health Fund points out that in the era of the coronavirus pandemic, telemedicine made it possible to contact a family doctor remotely. The patient could get an e-prescription or e-certificate without leaving home. The fund points out that the peak of the third wave of the COVID-19 epidemic is behind us, medical staff are already vaccinated, and yet NFZ data show that in some POZ clinics, still 70 percent. patient advice is teleportation. In extreme, but not uncommon cases, 9 out of 10 tips are over the phone.

These calculations are overlapped with numerous complaints and signals from patients regarding primary health care, directed to the Fund and the Patient Ombudsman. Patients most often indicate difficulties with calling their family doctor or the inability to arrange a direct visit to the GP surgery, which significantly reduces access to basic medical services.

The National Health Fund introduces changes. Less teleporting, more normal visits

For these reasons, the National Health Fund decided to change the ordinance regulating the principles of concluding and implementing contracts with POZ. The amended regulations reward clinics that will diagnose and treat patients on the spot, i.e. directly at the GP surgery. On the other hand, clinics that provide most of the services in the form of teleporting will receive a lower rate, corresponding to the reduced range of services available to the patient.

1. See also: How did Poles rate teleporadia?

The National Health Fund emphasizes that in the transitional period, i.e. in July and August, the caption rate of the primary care physician will depend on the fixed thresholds for the participation of telepaths in the total number of services provided. In the case of a GP, who gives less than 25 percent. remotely, e.g. by telephone, the basic capitalization rate will increase from PLN 171 to PLN 179,55. However, if this share exceeds 75%, then the capitalization rate will be PLN 153,90.

As of September 1, the bonus rules will be based on the median share of tele-advice in relation to the total number of services. Every month, the NHF will publish information on the percentage of telepaths in all health care consultations (for the previous month), including the median of their participation in all health care consultations in Poland.

Clinics that exceed this threshold 1,5 times a month will receive lower remuneration.

Institutions where the share of remote consultations will be twice lower than the threshold indicated by the National Health Fund in a given month, calculated on the national scale, can count on higher remuneration. The fund will apply the so-called corrector, i.e. the correction factor 1,05.

Patient rights spokesman Bartłomiej Chmielowiec on Wednesday at a press conference informed that most of the complaints currently addressed to the office of the ombudsman concern problems with access to basic health care services and the abuse of telepaths. He indicated that this concerned over 20 thousand. with 71 thousand all complaints that have reached the ombudsman’s office.

In 2020, the highest number of reports (31) on the Patient Telephone Information Center also concerned primary care. There were 958 complaints about outpatient specialist care services, and over 27 in hospital treatment.

author: Karolina Kropiwiec / PAP

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