The financial results of the Health Insurance Fund for the first half of the year 2015

In the first half of this year, the commission for health care services of the Health Insurance Fund amounted to EUR 362 million, which is approximately 25 million euros more than at the same period last year. Medicines were compensated for 56 million euros and the temporary disability benefits were paid for 65 million euros.

Compared to the first half of the last year the funding of health care has grown most in nursing care, whose budget has increased by 22%, or nearly three million euros. Also, the funding has increased for general medical (11%), specialist medical care (6%) and dental care (13%).

In the first half of the year 2015, family health care was funded for a total of 45.6 million euros, which is 4.6 million euros more than the year before. The increase is due to the price limits that have been growing since the beginning of the year - the additional fee of the second family nurse, the monetary base, the capitation fee, and the additional fee for the time outside of working hours. In addition, as a new opportunity will be funded the use of the therapy fund for the family doctors for referring to speech therapy and psychological services. Since 2015, the threshold of the study fund for all family physicians increased also.

In the first half of the year the Health Insurance Fund paid to medical institutions 286 million euros for about 1.7 million treatment cases of specialized medical care. The number of people to whom the services provided and funded by the Health Insurance Fund in the first half of the year has not grown.

On the basis of reports submitted to the Health Insurance Fund, as of 1 July, a total of 183 thousand appointments has been registered for the specialist medical care waiting lists. The number of appointments recorded for treatment waiting lists has increased by 15 thousand. The number of patients waiting longer than the allowed maximum waiting time has decreased, and more people receive the appointment within the allowed waiting time.

In the first half of the year of 2015, 72% of the scheduled first contact outpatient specialist medical care appointments of the Hospital Network Development Plan took place during the maximum allowed length of waiting list (up to 42 calendar days).

For provision of nursing services, the Health Insurance Fund paid 14.6 million euros in the first half of the year, whereas also the funding of the stationary nursing aid service has increased by 20%, as compared to the first half of the year 2014. Also, 18% more home nursing visits have been made. The result is to be expected, since the objective of the Health Insurance Fund is to improve the accessibility of independent nursing care, and in particular home nursing services and in-patient nursing care.

For dental services the Health Insurance Fund paid, during the first half of 2015, nearly 12 million euros. Discount drugs were compensated for on the basis of 4 million medical prescriptions to the extent of nearly 56 million euros. Compared to the same period last year, funding for medicinal products has increased by approximately 4%.

Temporary incapacity to work was compensated for 65 million euros, which is 8.6 million more than in the same period last year. The benefits of temporary incapacity to work have increased due to a higher average salary, the number of employed insured persons and the increased number of certificates for maternity leaves.

The full report can be read here.

The set of slides summarizing the results of the first half-year report.

Additional Information: Katrin Romanenkov  Public Relations Manager Estonian Health Insurance Fund  Tel 521 5655  katrin.romanenkov [at] haigekassa.ee