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Nine-month financial results of the Health Insurance Fund in 2014

PRESS RELEASE
03.11.2014

In the first nine months of this year the Health Insurance Fund funded healthcare services for 491 million euro which is 50 million euro more than in the same period last year. Medicines were compensated for nearly 81 million euro and temporary benefits for the incapacity to work were paid 79 million euro.

Compared to last year, resources for funding both specialized medical care, as well as nursing care, has significantly been increased. On the other hand the strengthening the family doctor system with funding being allocated for the activities of another family nurse directly from the family doctor, the possibility of providing appointments outside work hours and co-operation opportunities for family doctors and medical specialists in the form of an e-consultation have been supported. In the first half of the year, selection of the contract partners in specialized medical care and nursing care were carried out.

In 2014 during the first nine months, family health care was funded to the extent of nearly 62 million euro. Compared with the first nine months of 2013, family health care funding has increased by 8%. This year has been added financing of the activity fund of the family doctors and the provision for appointments outside working hours, allowing family doctors to provide patients with the necessary procedures and to serve the insured in the evening hours and on weekends. These innovations make family health care even more accessible to people and create a presumption that a person receives all necessary treatment through co-ordination with their family doctor and does not have to visit different doctors.

Within the first nine months of this year, appointments of family doctors outside working hours were provided by 29 lists and appointments by nurses were provided with 28 lists. In the case of appointments outside working hours, a family doctor or a nurse receives patients outside of normal working hours on weekdays 8-18. Appointments outside working hours have been provided by family doctors in the Viru and Harju Regions.

The total volume of the order of specialized medical care in the first half of the year was approximately 391 million euro, which is 42 million euro higher compared with the same period last year. There is an increase in the number of people who have gone to medical specialists, as well as the number of cases handled in specialized medical care compared to the same period last year.

The number of appointments registered in the waiting lists has increased in particular in the hospital network, where during the allowed waiting period more people received access to the appointments than in the same period last year. The number of initial planned outpatient visits to specialized medical care compared to the third quarter of the previous year increased by more than 15 000 (7%), including the number of appointments within the maximum waiting time limits increased  by 14 000 appointments.

During the first three-quarters of the year 2014, the Health Insurance Fund financed nursing care medical services in total for nearly 18 million euro, which is 21% more than in the same period last year. Home nursing services was nearly 19% more than in the three-quarters of the year 2013. The result is to be expected since the objective of the Health Insurance Fund is to improve independent nursing care, and in particular the availability of home nursing services and inpatient nursing care.

For dental services, the Health Insurance Fund in the third quarter of the 2014 paid nearly 15 million euro. Discount drugs were compensated for nearly 81 million euro. Compared to the same period last year the funding of medicines has increased by nearly 6%. When in the first half of 2014,  more than ten different new drugs were added to the compensation list, then starting from the third quarter in the list of compensated medicines were added six new drugs for the treatment of kidney cancer, type II diabetes, asthma, cataracts, and uterine leiomyoma’s. The range of the new drugs compensated for has expanded during the year 2014 significantly faster than last year.

Temporary incapacity to work was compensated for 80 million euro which is 6.5 million euro more than in the same period last year.

During the first three-quarters of the year 2014, the revenue from the health insurance part of the social tax has been less than has been predicted. It has also influenced the results of the Health Insurance Fund. The total net gain of the reporting period is minus 12.7 million euro, which is by 11.4 million more negative compared to the 9-month budget of the year 2014.

The full report can be read online at the page of financial data on the website including a set of slides summarizing the results of the 9-month report.