The costs of public health insurance will be over CZK 471 billion next year


Update: 19.09.2022 14:39

Prague – Next year, according to estimates by the Ministry of Health, the costs of public health insurance will amount to 471.7 billion crowns, of which 453.8 billion crowns will go directly to health care, and the rest to the operation or preventive funds of insurance companies. In the proposal reimbursement decrees according to the economic forecast, the ministry expects system revenues of 464.6 billion crowns, which is 7.1 billion crowns less than expenses. The difference is made up from the reserves of health insurance companies. Year-on-year costs for health services will increase by a total of 6.7 percent, i.e. by approximately CZK 28.5 billion. 3.4 billion crowns are also expected next year for care related to the covid-19 epidemic. The original agreement was on year-on-year growth for each segment by an average of four percent, the ministry increased it to eight percent.

In the first half of this year, seven health insurance companies negotiated with representatives of 14 segments of health care about the payment of care for next year. In the end, ten of them concluded the agreement. “The agreement was not concluded in the segments of providers of outpatient specialized services, providers of outpatient laboratory and radiology services, providers of follow-up inpatient care and providers of acute inpatient care,” the ministry said in the material. Emergency medical services and patient transport have been partially agreed. At the end of the conciliation procedure, the agreement for gynecology was also vetoed.

It is acute inpatient care, i.e. hospital, that accounts for roughly half of the costs. The division of costs is confirmed by the Ministry of Health in the autumn by issuing a reimbursement decree. In segments with concluded agreements according to their results, in other segments usually according to the proposal of health insurance companies. The acute inpatient care segment will grow by eight percent, and the follow-up care segment by ten percent.

“Since the time of the conciliation procedure, the estimate of the income of health insurance companies in 2023 has increased by about five billion crowns. For these reasons, which affect both the income side of the insurance companies and the cost side of the providers, the Ministry of Health decided to intervene in the concluded agreements in the public interest of stabilizing the health care sector and increase the total growth of payments from the original four percent to the new eight percent,” the document reads.

Care reimbursements are usually based on a comparison with the previous period and its increase by a certain percentage. For 2023, that reference year will be 2021, except in the area of ​​acute inpatient care, where it will be compared to 2019. care is exceptional and it is not appropriate to take it as a reference in this segment,” the ministry said.

Public health insurance income consists of premiums collected from employers, employees and entrepreneurs. The state pays a monthly amount for its insured, next year it should be 1900 crowns, about 123 billion crowns per year. In subsequent years, the payment will automatically increase or remain the same according to economic developments. Even in 2018, the monthly payment for state insured persons was roughly half.

State insured persons are, for example, the unemployed, children or seniors, totaling 5.9 million crowns. Although the state pays only a little over a third of the total income for them to the public health insurance system, they consume the majority of the costs. The costs of public health insurance increased almost fourfold between 2000 and 2020, also due to the payment of new expensive medicines. For this year, around 27 billion crowns are expected for central medicines, next year the amount will be 4.4 billion crowns higher.

Health care costs from public health insurance (in billion CZK):

2022 in total

2023 in total

Difference

total for health care

425,275

453,788

28,513

for outpatient care

113,506

121,304

7,798

for inpatient care

239,600

259,498

19,898

of which the cost of center drugs and gene therapies

27,604

32,022

4,418

to pharmacies, prescription drugs and medical devices

53,189

55,440

2,251

source: draft reimbursement decree


Source: České noviny – hlavní události by www.ceskenoviny.cz.

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