This is certainly a trend in the wrong direction. For years after the fall of the Soviet Union there has been a concerted effort to increase the autonomy of any country’s health insurance fund. The reasons are many and include the distinct mission of a fund from that of a ministry of health. In the private sector this is akin to the challenge of an insurance company delivering medical care. It can be done effectively, most times it is not.
Over the past few months, the NFZ (state health insurance fund) has increasingly turned to the private sector as a partner in the nation’s healthcare system, particularly for in-hospital stays. The NFS has even contracted with a private insurance company (Signal Iduna). And for some time now, with approximately 90% of primary care doctors and 60% of specialist in private practice, the NFZ has contracted with private doctors.
As with most post communist health care systems there is an over abundance of hospital beds and a mis-allocation of services. We look to the government to begin the serious decisions to close some hospitals. Along with the integration of all providers in delivering care, this will speed up the changes and bodes well for the key private players. Ideally, reimbursement for medical care should be made available to “any willing” provider offering best services at specific (e.g. contracted) rates. But politics reigns supreme right now in Poland.
In light of the political realities and need for change, here’s a short look at a few of the main players….
On the hospital side, those hospitals with NFZ contracts include SwissMed (see May 20007 issue) Enel-Med, EMC, and Damian. Luxmed (see April 2007) with its new owners Mid-Europa, is moving ahead with their new hospital and Medicover’s hospital should be ready within a year. No doubt this will push the second tier managed care operators to re-evaluate, e.g. Lim at number 3 and Enel at number 4 in market share.
Poland’s managed care sector, those established medical clinics run on subscription basis, is spot on. With their consistent revenue stream, driven from the growth in employment and fringe benefits, and greater quality expectations from the population at large, look to more deals like Luxmed in the coming months. Also, Enel-Med is considering a listing and listed company EMC Instytut Medyczny is expanding to Ireland.
Insurers like PZU Zycie and Signal-Iduna will likely begin to move into the provider side, which can, and most likely will, present them with new challenges. We’d much rather see the carriers’ efforts go towards legislative changes allowing tax deductions for health insurance.
The current private equity activity in the healthcare sector in Poland can be attributed in large part to Poland’s maturing market: it’s large, vibrant, and the population is getting wealthier. But the political challenges remain. In light of the MOH’s recent political moves, let’s see if the NFZ continues its progress towards accepting the private sector as an important part of Poland’s medical community….KW and HK
Health minister to have greater control over the NFZ
Last week Poland’s parliamentary deputies accepted the amendment to the Act on Healthcare Services Financed from Public Funds. One of the most important provisions of the amendment are those designed to increase the health minister’s control over the president of the National Health Fund (NFZ).