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Compensations for service providers

 

In accordance with the Government’s freedom of choice model, health and social services can be offered by unincorporated county enterprises and county-owned companies, private enterprises and third-sector operators. Under this model, the service providers will receive compensation from the county.

The incentive-driven compensation system must encourage service providers to offer effective services and promote the health and wellbeing of the citizens and their functional capacity. Service providers are expected to compete, above all, by providing high-quality services. As a rule, therefore, each county will pay an equal amount to all service providers for the provision of the same service.

Compensation to health and social services centres  

Under the model, proposed by the Government on 8 March 2018, counties will pay to service providers a monthly amount, which is a periodic fixed payment per client for the health and social services provided (so-called capitation). The compensation will be grounded on national needs-based factors, such as the age, gender, employment and socio-economic situation of the county residents.

When the fixed compensation is determined, attention must also be paid to the clients’ need of individual care and services or costs that may arise based on the client care plan.  The number and characteristics of clients will account for at least two thirds of the compensation paid to the service providers.

Besides the fixed payment, the county may pay to the health and social services centre

  • performance-based remuneration
  • incentive-based remuneration (based, for instance, on the quality and effectiveness of care) and
  • other remuneration (based, for instance, on a remote location).

Compensation to oral health services units

The county will pay a monthly compensation for oral health services, which will be a periodic fixed payment per client (so-called capitation). The compensation will be grounded on national needs-based factors, which are the age, gender and socio-economic situation of the county residents. 

In addition, when the fixed compensation is determined, attention must be paid to the clients’ need of individual care and services or costs that may arise based on the client care plan. The share of this so-called capitation for oral healthcare will be at least 50%.

Besides the fixed payment, the county may pay to the oral health services unit

  • performance-based remuneration
  • incentive-based remuneration (based, for instance, on the quality and effectiveness of care) and
  • other remuneration.

Compensation to oral health services units, 2022–2023

  • From 2022 to 2023, oral health services will be paid monthly compensation per client based on the nationally defined amount of compensation to service providers.
  • From 2022 to 2023, fixed compensation paid during the treatment period (service package) will be determined based on the contents of the most common treatment measures and their costs. The payment of the fixed compensation ends at the conclusion of the treatment period. The length of the treatment period may vary based on the client's need.
  • In addition to fixed compensation, performance-based remuneration may be paid.

Compensation for services provided by unincorporated county enterprises

Services vouchers granted by the counties 

  • The county will pay compensation to the service provider up to a pre-determined value for the cost of services provided to the client holding a health and social services voucher, granted by the unincorporated county enterprise.
  • As the services to which services vouchers can be used are not consistently commercialised, the content of the services and the value of the voucher can be decided by the county.
  • For different service providers, the health and social services voucher must be of the same value for the same service package.
  • The health and social services voucher can be linked to an incentive-based amount, which will be payable to the service provider in case the service meets the quality and effectiveness criteria, pre-determined by the county.
  • Clients, who use services covered by the health and social services voucher, will pay a client fee to the county. 

Services covered from personal health budget

  • The compensation will be paid directly to the service provider, selected by the client (that is, not in cash to budget holder). The personal health budget will be a financial obligation designed for the organisation of individual services and support.
  • The personal health budget will be calculated on the basis of assessment of need for services and client care plan. In estimating the amount of the personal health budget, the need of different services must be taken into account as well as how much the provision of these services in an unincorporated county enterprise would cost.
  • The client will be personally responsible to the service provider for the costs of services that are not included in the client care plan related to the personal health budget.

Materials

Inquiries:

Pia Pekola, Senior Officer, Ministry of Social Affairs and Health, tel. +358 295 163 694
Mikko Meuronen, Senior Officer, Ministry of Social Affairs and Health, tel. +358 295 163 641