The Agency for Health Technology Assessment and Tariff System has completed the work on new tariffs for the provision of health care services covering neonatal care.
In the last decade, technical advances in perinatology and improvements in care (e.g. early diagnosis, monitoring of pregnancies at risk) meant that the possibility of survival of extremely immature newborns has improved significantly, and the diagnosis of congenital malformations and genetically determined diseases often occurs already in the foetal period. Providing medical care at a level that meets modern requirements will require good regional organisation, appropriately educated and experienced medical teams, wards equipped with modern equipment and hospitals that provide specialist care twenty-four hours a day.
Adjusting the valuation of priced services to the real costs incurred by healthcare providers will make it possible to ensure a better standard of service provision by making reimbursement amounts more realistic.
In the course of work with the expert community in the scope of neonatal pathology, 7 new billing products were developed in the scope of hospital services in the DRG catalogue, and the changes introduced will mean an increase in the total expenditure on neonatology services.
It should be emphasised that the new billing groups will make it possible to ensure the highest standard of treatment and care for newborns born prematurely and newborns requiring in-depth diagnosis.
The proposed changes in billing products are aimed at cleaning up the system, as well as rationalising settlements between healthcare providers and the payer. Adding new conditions related to the age of the newborn and the length of hospitalisation, as well as ordering the diagnoses required for billing and the procedures performed, will allow for better adjustment of services. The creation of the group Severe pathology in premature newborns > 30 days is a crucial element, as it will allow to maintain a high standard of treatment for newborns with birth weight < 1000g and/or born before the end of the 28th gestational week. Also the valuation of the group Newborn requiring extended diagnosis is of key importance, as it will allow full diagnosis, which has not always been performed due to the significant financial burden on healthcare providers, to be carried out.
It has been estimated that, compared to 2019, the increase in expenditure on guaranteed services including neonatal care will amount to PLN 241 million (21%). It is worth emphasising that the modification of the valuation of services provided in neonatal wards is aimed at harmonising them with current clinical practice, and adjusting the valuation of services to the real costs incurred by healthcare providers will make it possible to ensure a high standard of service provision by making the amount of reimbursement more realistic.
Following the approval of the draft tariffs by the Minister of Health, the Announcement of the President of the Agency for Health Technology and Tariff System on the tariffs for guaranteed health care services in the scope of neonatal care was published in the Public Information Bulletin of the AOTMiT.