• The Director of the NHIF Dr. Komitov: my greatest desire is for hospitals not to have determined budgets

    May 13, 2015

    The NHIF does not fund hospitals, but the services provided to the patients who visited the hospitals, stated Dr. Glinka Komitov, Manager of the NHIF, in front of the media. He noted that this was the reason for having to make adjustments to some hospitals’ budgets. According to him, most patients go to those hospitals where there are highly specialized personnel and high-tech equipment.

    “If a reputable doctor from a certain hospital last year, went to work in another hospital on the same or a different territory – in another location, patients would follow the doctor. They would not visit the medical establishment they had gone to up to that point any more, since they had not visited the hospital, but the reputable doctor – the good, highly qualified specialist. Not surprisingly, in some hospitals, such as the specialized ones, part of the patients from the Oncology Hospital in Sofia for example, have already been visiting a private hospital, as the good, the very good doctors from the Oncology Hospital in Sofia are now working in the private hospital. Therefore, this resource is not simply redistributed to a given hospital, but because more patients visit this hospital, because of the presence of its employed highly skilled professionals,” he explained.

    Commenting the case of the additional funds for hospitals, Dr. Komitov said: “I will propose to the Supervisory Board to increase the hospital resources of 146 of all 364 hospitals in the country. This proposal will not be based on which hospital should get how much, but on the justified requests of the medical institutions. Some hospitals want BGN 16 thousand, others – 2 or 5 million. All this will be presented to the Supervisory Board. Our funds for hospital care were 1.3 billion, but the Law on the NHIF Budget has the opportunity to advance funds from the Health Insurance Fund Reserve in the amount of 10% of the total revenue, or BGN 301 million. Up to BGN 5 million could be spent on primary care, up to BGN 10 million – on specialized care, and up to 5 million – on medical diagnostic aid, while  hospital care is allowed to be given up to BGN 180 million from the reserve in advance ” .

    Dr. Komitov said his greatest desire was for hospitals not to have determined budgets, but to got paid for all activities performed. He, however, noted that for this to happen there should be greater control. “We will pay for the respective amounts of activities, as long as they are done according to the respective prices we have agreed upon,” said the Manager of the NHIF. According to his words, the medical institutions should concentrate solely on the quality of their medical care for patients.

    The NHIF can perform inspections only after the events, said Dr. Komitov. He noted that if a breach was caught in a hospital now, it could not be sanctioned immediately, but would have to wait for the activity to be reported. According to him, under these circumstances, no employee would account for that activity and would report double for another clinical path. This requires changes to the existing legislation. Dr. Komitov added that both types of control should merge – the financial and medical control. According to him, the control authorities should conduct inspections suddenly and impose sanctions immediately, without reporting the activity. “To have transparency, we need the NHIF to publish the inspection information every month on the site, with the names of the hospitals and the violations found,” said he.