Too low valuation of services by NFZ

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The valuation of services by NFZ does not correspond to the real costs of medical services, the implementation of which often deepens the debt of hospitals. The scale of the problems is shown by calculations of the amounts of some medical examinations and services, which were presented by doctors via the website of the Residents’ Agreement. The medics add that NFZ pays only for one procedure of the treated patient, so in the case of people with many health problems, their treatment simply does not pay off.

Medics have been reporting on the bad situation in the Polish health service for a long time. The main problem is finances, and one of the protest demands is an increase in the amount for providing services from NFZ. Calculations presented on the website of the Agreement show that the current valuation of services by NFZ has little to do with the actual costs of provided services. According to doctors, NFZ pays PLN 11 for a diagnostic visit to a dentist, PLN 20 for extraction of a single-root tooth, and PLN 30 for extraction of an eighth. The situation is similar for other medical examinations and services, which can also be seen from the price list of medical visits. NFZ allocates PLN 29, which is a gross amount, for a patronage visit of a newborn at home, PLN 9 for a check-up visit in an oncological clinic, and PLN 8 for a check-up visit in a pulmonological clinic, while the monthly cost of POZ was priced at PLN 18 per patient. For ANA (antinuclear antibodies) test NFZ pays only PLN 35, while the price in the laboratory is PLN 90.

Hospitals cannot afford to treat patients?

As emphasised by medics, NFZ finances only one service per one patient, although doctors in internal medicine wards often treat multiple diseases in patients. According to Piotr Pisula, chairman of the Residents’ Agreement, such a system causes hospitals to lose resources and increase their debts. This is also confirmed by Paweł Doczekalski, a family doctor and the president of young doctors in the Regional Chamber of Physicians, who believes that it is not profitable to carry out certain tests and that the NFZ cart does not include the latest and best medical tests. The financial situation in the Polish health service is also not favoured by the growing inflation which is not taken regularly into account in the valuation of NFZ services.

NIK evaluates NFZ

The Supreme Audit Office’s (NIK) inspections of medical services between 2015 and 2020 show that the system for valuing research and services was not effective. Although – according to NIK – both the Agency for Health Technology Assessment and Tarification and the National Health Fund generally performed their tasks correctly, there were several irregularities concerning the process of conducting valuations. The Supreme Chamber of Control revealed that the heterogeneous way of conducting cost accounting in medical entities was a factor that made it difficult to obtain the data necessary to develop tariffs by the Agency. It led to the prolonged process of valuation of services, and this, in turn, translated into a poor realisation of tariff plans, which amounted to 33%.