Medical facilities owed to Social Insurance Company at the end of April 2013 on unpaid premium over € 61.5 million. Since the end of last year is it an increase of more than 12.8 million euros. Receivables of state medical facilities have reached the end of April more than € 35.9 mil.; i.e. 58.4 per cent of the total receivables. Compared with the previous month it increased by 4.5 million. Despite the fact, their debts were paid by State at the end of 2011. Transformed health care facilities owed to Social Insurance Company more than € 25.5 million. Compared with the previous month, debts increased by 1.4 million. Spokeswoman of Ministry said that the Ministry of Health monitors the development of the debt in Social Insurance Company.
Association of Hospital in Slovakia (AHS) has recommended to hospitals which associate to not sign the contracts with health insurance company Union. Association attitude will change only if the smallest private health insurance company Union raises payments to hospitals for five to ten per cent. This condition is based on the attitude of the state General Health Insurance Company (Všeobecná zdravotná poisťovňa – VšZP), which stated that if the amount of the payments by competitor will not be the same, the company will withdraw contracts with hospitals. Lower payments to hospitals currently give only health insurance company Union. General Health Insurance Company (GHIC) submits a proposal for new terms and conditions to AHS. In it is included the condition that if hospital will have a contract with an insurance company competitive with lower prices for finished hospitalization than is paid by General Health Insurance Company, GHIC will pays only the price of competition.
Government approved the proposal that guarantees next stage of increasing the salaries of doctors. The proposal of amendment to the Act on Health Insurance, which modify the salaries, is based on an agreement between the Minister of Health and Medical Trade Unions association. Salaries of doctors will rise two times. Necessary funds for increasing of salaries must find hospitals by themselves, whereas for this purpose are not allocated any special resources. Small and medium-sized hospitals associated under the Association of Hospitals of Slovakia (AHS) do not have money for further increasing the salaries. AHS therefore wants to initiate negotiations with insurance companies to raise funds for small and medium-sized hospitals. Since January 2014, salaries should increase on 1.25-fold of the average national wage for the doctors without attestation and 2.1-fold for the doctors with attestation.
Debt in health care (measured as overdue liabilities) reached at the end of last year € 213 million. Liabilities of state facilities amounted 141.7 million euros, representing an increase of 72.3 million. The largest part of the debt and generate teaching and university hospitals, with the exception of hospital in Nitra. Health care facilities transformed into joint stock companies, which do not show any overdue liabilities. According to estimation by Health Policy Institute (HPI), at the end of the year 2013 may debt exceed amount of 300 million. €. From previous experience, HPI consider this limit from the view of suppliers’ patience as critical. Therefore HPI assume that in 2014 will be needed another debt elimination of hospitals.
In 2010 Health Policy Institute and rodinka.sk in Slovakia started Maternity Hospital Guide. It is a project to monitor and improve quality of care in Labor and Delivery Rooms. This project brings a new quality assessment in L&DU on the Internet so that pregnant women do not have to rely solely on secondary sources of information, but they can read the direct information from Labor & Delivery Units itself.
Hospitals, which will do more surgery, will get more money. For each patient after surgery in 18 selected surgical disciplines should get hundred euros extra. This is new philosophy of funding by General Health Insurance Company (VšZP) which should be valid from April this year. This new way of funding is relevant for all university, teaching and general hospitals. The aim of this measure is to decrease the waiting times. State General Health Insurance Company also wants to check the evidence for waiting lists in hospitals. If it finds that some patients are preferred or there is mess in evidence, hospital receives a fine. If hospital fails to dispose patient from evidence, at first notify the provider and after repeated warnings, the hospital may not gets paid for the surgery or gets paid only part of it.
Debt of medical facilities on unpaid premiums to the Social Insurance Company reached at the end of February 55.1 million euros. Compared to the end of 2012, there was an increase in receivables of € 6.4 million. Debts of facilities in the scope of Ministry of Health represented at end of the February more than 56.2 per cent of total assets, i.e. 31 million euros. Compared to January, the debts increased by more than 2.5 million euros. Transformed medical facilities have debt of € 24.1 million. Compared with the previous month, receivables of these medical facilities increased by almost 700.000 euros.
Staff members of hospital who owe to Social Insurance Company on outstanding contributions do not have to be worried. According to spokesman of Social Insurance Company, they are entitled to a benefit from Social Security even if the employer unpaid the premiums.
DRG system, more transparent and equitable system of hospital payments, should work in 2016. Since April the Healthcare Surveillance Authority will start to train people. Training of nearly 3.200 people wants to catch by the end of next year. Trainings will cost more than seven million euros and should be paid mainly from EU funds. Eight people have been already trained in Germany, in a country whose DRG model we assume. The model will cost 1.4 million euros. The introduction of the new system is perceived positively by several hospitals and health insurance companies.
Materials for teaching health professionals who will be responsible for the launch of a new system of financing hospitals in practice are ready. However, the legislation is still lacking. Without it, according to the President of Healthcare Surveillance Authority Monika Pažinková, it cannot start.
Minister of Health Zuzana Zvolenska wants the public hospitals were in balanced economy in 2015. Ministry of Health wants to erase debts in next two years in its 13 facilities – the big university and teaching hospitals. Late last year, these hospitals owed about 320 million euros. Half of this amount consisted of overdue liabilities. How long hospitals pay invoices, the ministry does not know. Suppliers complain about long, even several years repayment period. Ministry wants to make hospitals align their management especially by layoffs, buying cheaper medicines, reducing operating costs and increase the charges.
Reducing the loss of public hospitals began Ministry of Health already last. Loss of 156 million euros, according to Minister Zvolenska, hospitals cut to 116 million last year.
Debt of medical facilities to the Social Insurance Company on unpaid premiums reached 48.7 million euros at the end of 2012. Compared to November 2012, there was a decrease in account receivables of € 6.8 million. According to the Social Insurance Company, debt has annually increased of 29.9 million euros.
At the end of 2012, debt of facilities managed by the Ministry of Health accounted more than 53 % of total assets, i.e. € 25.8 million.
State hospitals were forced by government to pay its debts to the Social Insurance Company at the end of last year. Together five medical facilities have paid 10.4 million euros. Two months later, again generated a loss and to Social Insurance Company owes even more.
The biggest problems have hospitals managed by county. Up to 15 hospitals in the scope of regions is drowning in debt. At the end of 2012, their debts on contributions to Social Insurance Company amounted to more than € 22 million, what is half of all hospital debts.