Table 1 Provider payment methods used to pay for health care services in Poland
From: How COVID-19 has changed the utilization of different health care services in Poland
Types of health services | Pre-COVID-19 pandemic provider payment methods | Changes to payment methods for non-COVID-19 services during the pandemic (2020–2021) |
|---|---|---|
Primary health care | - capitation (physician, nurse, midwife, and school nurse or hygienist care including most of the preventive services provided under primary health care) - fee-for-service (selected expensive diagnostic tests and certain types of consultations including cardiovascular disease prevention services, cervical cancer prevention programme services, and midwife visits) - lump sum (night and holiday care) | - capitation payment also covering teleconsultations (2020) - financial incentives (an increased capitation rate) to reduce the share of teleconsultations (2021) - advance payment for contracted services paid on a fee-for-service basis (2020) - add on payments (3% of the bill) to cover the cost of the elevated sanitary regime |
Outpatient specialist care | - per visit payment adjusted for number and type of services provided during a visit (services provided outside the hospital network) or global budget (services provided within the hospital network) - fee-for-service for services billed separately (e.g. cost-intensive diagnostic services and other groups of specialist services) | - possibility of visits in the form of teleconsultations (2020) - advance payment for contracted services paid on per visit basis and with fee-for service (2020) - lifting limits on services paid for per visit (July 2021) - applying per visit payment to all providers, including hospitals in the network (July 2021) - an add on payments (3% of the bill) to cover the cost of an elevated sanitary regime |
Hospital care | - global budget (lump sum) (within the hospital network) or DRG (outside the network) - fee-for-service (specific or highly specialized services, e.g. diagnostics for organ transplantation and organ transplantation, electrochemotherapy, and radiotherapy services) | - advance payment for contracted services paid for with DRG and fee-for service (2020) - an increase in the prices of services by about 5% (2020) - add on payments (3% of the bill) to cover the cost of the elevated sanitary regime |
Preventive health programmes | - fee-for-service | - an advance payment for contracted services (2020) - add on payments (3% of the bill) to cover the cost of an elevated sanitary regime |
Dental care | - fee-for-service | - an advance payment for contracted services (2020) - add on payments (3% of the bill) to cover the cost of the elevated sanitary regime |
Psychiatric care and addiction treatment | - person-day (most services in stationary and day care) or fee-for-service (outpatient care) - monthly lump sum (only centre for environmental psychological and psychotherapeutic care for children and adolescents) | - an advance payment for contracted services paid for on a per visit and fee-for service basis (2020) - possibility of a visit in a form of teleconsultations (2020) - add on payments (3% of the bill) to cover the cost of the elevated sanitary regime |
Medical rehabilitation | - fee-for-service (outpatient and home settings) or person-day (stationary and day settings) | - an advance payment for contracted services (2020) - introduction of teleconsultation and new fee for teleconsultation (2020) - add on payments (3% of the bill) to cover the cost of the elevated sanitary regime |
Health resort rehabilitation | - person-day (outpatient and stationary settings) | - an advance payment for contracted services (2020) - add on payments (3% of the bill) to cover the cost of the elevated sanitary regime |
Long-term care | - person-day (home and stationary settings) | - an advance payment for contracted services (2020) - add on payments (3% of the bill) to cover the cost of the elevated sanitary regime |
Palliative care | - fee-for-service (outpatient settings) or person-day (home and stationary settings) | - an advance payment for contracted services (2020) - add on payments (3% of the bill) to cover the cost of an elevated sanitary regime |
Outpatient medicines | - based on the established financing limit per medicine package with total reimbursement budget for medicines of no more than 17% of the total NHF budget for health care | - no changes |
Medical devices | - based on the established financing limit for a given medical device | - no changes |