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Unique identification number for achieving universal health coverage in Slovenia

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Presentation by Martina Zorko Kodelja (Health Insurance Institute of Slovenia) at the international conference on innovations in Civil Registration and Vital Statistics (CRVS) systems - Ottawa on 27-28 February 2018. See more at http://crvsinnovations.net

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Unique identification number for achieving universal health coverage in Slovenia

  1. 1. Unique identification number for achieving universal health coverage in Slovenia Martina Zorko Kodelja Consultant, Information Centre Health Insurance Institute of Slovenia
  2. 2. Slovenia – Small, beautiful and unique General facts • 2 million inhabitants • 20.273 km2 • 34.063 $ GDP per capita • Ljubljana is the capital city, 280.000 inhabitants • Member of EU since 2004 Health indicators • Life expectancy – male: 77,8 years (OECD: 77,9) • Life expectancy – female: 83,9 years (OECD: 83,1) • Infant mortality: 1,9 (OECD: 3,9) • Population coverage: 100 % (OECD: 97,9 %) • Share of out-of-pocket expenditure: 2 % (OECD: 3 %) Unique identification numbers Unique citizen number Tax number Health insurance number
  3. 3. Unique citizen number is assigned at birth in a hospital 20.000 births per year 99 % of births in hospitals 14 hospitals Hospital IT E-Births app Central register of population Register of civil status Unique citizen number Date of birth Time of birth Gender Name and Surname Vitality Mother data Father Data Other
  4. 4. Effective in managing compulsory health insurance Health insurance institute of Slovenia • The only provider of compulsory health insurance in Slovenia • Budget: 2,5 Billion EUR • 1,7 % of the budget for operating costs of HIIS • 853 employees Central register of population Health insurance database Daily exchange of data on new entries (new unique citizen numbers) in the CRP and on changes of data in the CRP (change of address, surname…) New health insurance number is dedicated to each new unique citizen number. This is the basis for inclusion into health insurance and issuing of the health insurance card. HIIS Collecting insurance payments from contribution obligors Ensuring the rights to health care services and financial benefits to insured persons Paying for healthcare services to healthcare providers
  5. 5. Successful at including people into health insurance scheme • By law, everyone with permanent residence in Slovenia must be included into health insurance scheme • Population coverage = 100 % • HIIS is obliged to systematically invite everyone, who does not have a valid health insurance for more than 20 days, to get included into health insurance scheme • If contributions for insurance are not paid, the health insurance rights are temporarily withheld. Only urgent healthcare services are available to such persons (20.000 people does not have paid contributions). • Everyone can check the validity of their insurance (using their health insurance number) on the portal or with a mobile phone. 2016 insured persons family members all % workers 755.940 412.832 1.168.772 56% entrepreneurs 73.024 31.749 104.773 5% farmers 12.153 6.619 18.772 1% pensioners 546.669 31.679 578.348 28% unemployed 19.019 5.268 24.287 1% citizens with no income 50.683 11.962 62.645 3% persons who pay contributions themselves 56.662 10.835 67.497 3% others 45.831 15.293 61.124 3% 1.559.981 526.237 2.086.218 100%
  6. 6. Rationally paying for healthcare services • Health insurance card of the patient must be presented each time, when using healthcare services. • Healthcare providers charge each service per person (based on the health insurance number). • Automated procedures, paperless billing, more than 600 automatic controls. Business intelligence • HIIS is collecting detailed data of healthcare services, medicines, medical aids, other used rights. • Areas of analyses: costs of medicines, costs of acute hospital treatments, sick leave trends, … • Data warehouse and analytical system for supporting: • decision making, • tracking business results, predicting future trends, • finding errors and fraud, • discovering and promoting good practices of quality and efficiency of healthcare services, • preparing further development steps. Nationally important: • Comparability of statistical and accounting data • Analytical data for planning and strategic decision making
  7. 7. Thank you! Questions welcomed! Martina.Zorko-Kodelja@zzzs.si Photos by: Marijan Močivnik Studio Ajd, Marko Šinkovec, Nea Culpa d.o.o., Jošt Gantar, Iztok Medja, Ubald Trnkoczy, Aleš Frelih, www.slovenia.info

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