The Supervisory Board of the Health Insurance Fund approved the Health Insurance Fund Development Plan
The meeting of the Supervisory Board of the Health Insurance Board held on September 11 approved the Health Insurance Fund Development Plan for the years 2016 - 2019. Over the next four years, the priorities will be to ensure the availability of quality health services and the further development of services provided in first-contact care. The focus lies on the implementation of a holistic and coordinated approach to the patient in health care, disease prevention and development of a strategic conception for the purchase of services and of e-services.
On improving the availability of health care services, it is important in the coming years to pay significant attention to the development of family health care and to achieve the optimal use of specialized medical care services. Hereby, what is important is the consistent development of e-services, the continued support of the free movement of patients and the holistic approach to the patient. The development plan aims at finding solutions to reduce waiting times both in health care institutions as a whole and in individual specialties.
One of the major tasks in ensuring the sustainability of the solidarity of national health insurance in the coming years is the strengthening of the strategic purchasing concept. Strategic purchasing must support a more patient-centered, holistic organization of treatment based on the assessment of the quality of the treatment, the patient's freedom of choice and the effective use of resources. It is also important to promote the necessary investments in the Estonian health care system based on independent service providers. The remuneration methods and the pricing used by the Estonian Health Insurance Fund must motivate health care providers to increase the quality, cost efficiency, and consistency of diagnostics and of the treatment process. Consequently in the coming years, emphasis will be placed on the development of methods of remuneration taking into consideration the developments in the health care system, which would support a more patient-centered organization of treatment and the use of therapies more sparing for the patient.
The development of the treatment quality system is one the most important priorities for the Estonian health care system and health insurance, the implementation of which will benefit patients, healthcare providers and the community at large. The Health Insurance Fund will contribute significantly to the creation and the implementation of a comprehensive quality system in Estonian health care which attaches great importance to standardization of the treatment process as well as the measurement and a comprehensive evaluation of the results of the treatment (process). It is important to develop Estonian-specific treatment guidelines because, in addition to the data of clinical trials, the circumstances of the state and the organization of health care must be taken into account. In the view of achieving high-quality results, it is important to measure the set standards and to provide feedback to the parties.
Disease prevention and raising of health awareness, among other things, by implementing evidence-based services, screening programs and using modern information technologies, are the sectors of the growing importance of the Health Insurance Fund Development Plan and its activities. Prevention activities help to detect diseases as early as possible, on the one-hand, and, therefore, to maintain the quality of life of people, on the other hand to reduce the formation of expensive treatment cases. Disease prevention includes both guiding the patient's health behavior through increasing their awareness, as well as a number of health care services included in the health insurance package of the Health Insurance Fund.
An important part of the Development Plan is supporting the comprehensive development of the entire e-Health Information System because it allows the most efficient use of resources to achieve the optimum results. The potential of the Health Information System needs a systematic and large-scale implementation, in order to realize its real possibilities. It relates to both collection of the data from the central system and information exchange, including e-referrals, software developments of service providers, allowing consideration of integral health information as a support of each individual treatment decision, as well as more effective cooperation between the parties for the best results, involving also the patients.
The full text of the Health Insurance Fund Development Plan is available here.
Brief summary of the Development Plan is available here.