At the beginning of January 2015, the healthcare services pricing process was transferred from the National Health Fund to the Agency for Health Technology Assessment and Tariff System. The tariff setting process aims mainly at the healthcare services pricing, adequate to real treatment costs incurred by medical care facilities and independent of the payer (National Health Fund). The tariffs are also supposed to balance the supply of healthcare services and patients’ demand, ensure the highest possible availability of guaranteed benefits and economy in spending public funds.
Key audit findings
The value of healthcare services financed in 2019, for which the CEO of the Agency for Health Technology Assessment and Tariff System published tariffs exceeded PLN 15 billion, whereas the costs of healthcare services totalled over PLN 90 billion. It means that only less than 17% healthcare services were covered by the tariff system.
In 2015–2020, the Agency for Health Technology Assessment and Tariff System properly performed its tasks related to the tariff setting for healthcare services, under the Act on healthcare services. The Agency CEO developed tariff setting plans for the given year in due time and submitted them for approval to the Minister of Health, including opinions of the President of the National Health Fund and the Tariffs Council. NIK underlines that the tariff setting plans were executed only in 33%. In the audited period, tariffs were not established for 1500 of 2226 healthcare services, which were singled out in the tariff setting plans or ordered by the Minister of Health (works on 776 tariffs were suspended, 299 tariffs were withheld and 426 tariffs were in progress).
