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Statistical information on cross-border health care in Finland 2017

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Statistics provided by the Contact Point for Cross-Border Health Care in Finland and Kela (the Social Insurance Institution of Finland) include information on cross-border healthcare, European Health Insurance Card (EHIC), medical care costs incured abroad and their reimbursements, and prior authorisations for seeking treatment abroad.

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Statistical information on cross-border health care in Finland 2017

  1. 1. Statistical information on cross-border health care in Finland May 31, 2018
  2. 2. Table of contents 1. Medical costs incurred in EU and EEA countries and in Switzerland and their reimbursements 2. Top 5 countries: medical costs and their imbursements when seeking treatment independently 3. Medical costs incurred outside EU and EEA countries and Switzerland and their reimbursements 4. Top 5 countries: Medical costs incurred outside EU and EEA countries and Switzerland and their reimbursements 5. Prior authorisation provided in Finland for treatment provided in an EU or EEA country or in Switzerland and information on the costs 6. Amounts Kela has invoiced EU and EEA countries and Switzerland for treatment provided in Finland on the basis of prior authorisation (€) 7. State reimbursement to public health care for treatment costs 8. Debts and receivables for medical costs between Finland and other EU and EEA states and Switzerland 9. Numbers of European Health Insurance Cards (EHIC) issued by Kela 10. Contact Point for Cross-Border Healthcare 2
  3. 3. • The costs have been incurred from sudden illness and seeking treatment independently. • Sudden illness means that the need for treatment has occurred during a stay abroad. • Seeking treatment independently means that the customer has travelled abroad with the purpose of receiving treatment and they do not have prior authorisation pursuant to EU regulations. • Necessary treatment means situations where the treatment costs have been reimbursed in accordance with the customer fee of Finnish public health care (Act on Cross-Border Health Care). • Physiotherapy, dentist’s fees, medicines, doctor’s fees, travel and examination and care may relate to situations of either sudden illness or seeking treatment independently. The reimbursement has been paid in accordance with the Health Insurance Act. • The number of resolutions means the number of decisions given to customers. One resolution or decision may include one or more procedures, examinations, treatments, medicines or travels. Kela does not keep statistics of the numbers of people. • The statistics are compiled according to the resolution date. Reimbursement must be sought within half a year of paying the costs. Therefore, the treatment relating to the statistics may have been given the year before. • More information: kela.fi/sairaanhoito-kansainvalisissa-tilanteissa-jos-sairastut-ulkomailla 1. Medical costs incurred in EU and EEA countries and in Switzerland and their reimbursements Source: Kela Number of resolutions Costs € (paid by customer) Paid reimbursements € 2017 2016 2015 2017 2016 2015 2017 2016 2015 Physiotherapy 81 118 103 16,886.37 25,138.16 19,951.98 2,846.00 4,071.15 5,076.60 Dentist’s fees 6,376 8,302 7,182 2,277,408.59 2,715,258.26 2,331,139.23 305,339.84 491,616.64 582,739.01 Medicines 1,796 2,194 1,891 222,539.49 178,440.20 177,741.14 86,774.32 65,231.26 72,937.01 Doctor’s fees 2,114 2,798 2,771 548,380.99 712,896.54 699,181.96 85,213.61 118,926.18 130,563.29 Travel 1,361 1,570 1,236 310,352.20 336,669.93 279,376.13 106,698.96 147,506.45 123,943.53 Examination and care 3,234 4,191 3,884 224,199.64 317,244.97 373,372.87 72,481.29 114,762.07 131,734.45 Necessary treatment 7,098 7,163 4,973 4,874,782.06 3,948,474.85 2,119,473.50 4,025,266.16 3,191,131.68 1,655,229.96 3
  4. 4. 2. Top 5 countries: medical costs and their imbursements when seeking treatment independently • The costs are the price charged to the customer abroad for which they have applied to Kela for reimbursement. • The costs have been incurred from seeking treatment independently abroad, i.e. the treatment has been sought without prior authorisation. • Kela reimburses the costs of seeking treatment independently if the treatment has been provided in an EU or EEA country or in Switzerland. • Treatment costs are reimbursed in the same manner as treatment given in Finnish private health care. • Medicine expenses are reimbursed in the same manner as medicines purchased in Finland. • Travel costs are reimbursed in the same way as if the customer had travelled to the health care unit closest to their home address where they would have received the necessary treatment. • The statistics are compiled according to the resolution date. Reimbursement must be sought within half a year of paying the costs. Therefore, the treatment relating to the statistics may have been given the year before. • The majority of the reimbursements for health care costs are reimbursements for dental care provided in Estonia. More detailed information on the treatment is not available. • More information: kela.fi/sairaanhoito-kansainvalisissa-tilanteissa-hoitoon-hakeutuminen-ulkomaille In 2017 Country Costs € Reimbursements € 1. Estonia 2,679.000 410,000 2. Spain 324,000 35,000 3. Germany 154,000 8,000 4. Hungary 109,000 8,000 5. Sweden 42,000 3,000 In 2016 Country Costs € Reimbursements € 1. Estonia 3,390,000 650,000 2. Spain 440,000 56,000 3. Hungary 130,000 8,700 4. Germany 112,000 9,700 5. Belgium 48,000 2,100 Source: Kela 4
  5. 5. 3. Medical costs incurred outside EU and EEA countries and Switzerland and their reimbursements • The costs have been incurred from sudden illness. • Sudden illness means that the need for treatment has occurred during a stay abroad. • The reimbursement has been paid in accordance with the Health Insurance Act. • The number of resolutions means the number of decisions given to customers. One resolution or decision may include one or more procedures, examinations, treatments, medicines or travels. Kela does not keep statistics of the numbers of people. • The statistics are compiled according to the resolution date. Reimbursement must be sought within half a year of paying the costs. Therefore, the treatment relating to the statistics may have been given the year before. • More information: kela.fi/sairaanhoito-kansainvalisissa-tilanteissa-jos-sairastut-ulkomailla Number of resolutions Costs € (paid by customer) Paid reimbursements € 2017 2016 2015 2017 2016 2015 2017 2016 2015 Physiotherapy 63 58 45 33,901.24 26,857.29 20,770.33 2,202.98 1,439.38 1,499.83 Dentist’s fees 94 116 133 39,237.31 49,731.25 61,935.57 4,542.39 6,186.61 9,587.11 Medicines 860 967 733 65,803.78 135,196.87 85,423.82 12,880.12 15,883.89 15,746.02 Doctor’s fees 2,436 2,943 2,128 1,609,308.97 1,299,174.37 877,999.02 125,430.29 150,806.55 119,386.61 Travel 82 103 117 59,382.20 47,622.57 130,510.15 4,669.65 634.01 890.43 Examination and care 1,532 1,576 1,087 1,344,983.98 942,897.23 532,544.01 94,738.50 128,441.84 80,804.32 Source: Kela 5
  6. 6. 4. Top 5 countries: Medical costs incurred outside EU and EEA countries and Switzerland and their reimbursements In 2016 Country Costs paid by customer (€) Reimbursements (€) 1. Thailand 1,550,000 92,000 2. USA 1,230,000 33,000 3. Turkey 1,110,000 92,000 4. Russia 186,000 14,000 5. China 168,000 14,000 In 2017 Country Costs paid by customer (€) Reimbursements (€) 1. USA 2,590,000 37,000 2. Thailand 1,535,000 81,000 3. Turkey 1,047,000 62,000 4. Mexico 264,000 4,000 5. China 174,000 6,000 Source: Kela 6
  7. 7. 5. Prior authorisation provided in Finland for treatment provided in an EU or EEA country or in Switzerland and information on the costs Year Resolutions Granted Denied Not processed Amount paid by hospital districts for treatment covered by the prior authorisation, €* 2017 200 106 82 12 213,332 2016 246 126 113 7 510,160 2015 197 98 97 2 567,239 2014 181 76 104 1 165,239 2013 140 59 81 1,124,559 • Under certain conditions, Kela may grant prior authorisation for treatment in EU or EEA countries or Switzerland. Prior authorisation is not granted for treatment outside the EU. • Kela grants prior authorisation according to the statement by public health care. • When a patient receives treatment abroad on the basis of prior authorisation, the country providing the treatment invoices Kela for the actual costs of treatment and collects a client fee from the patient. Kela pays the costs and invoices them to public health care. • The prices of treatment may vary considerably: a single treatment may cost between 100 and 100,000 euros. Therefore, the amounts in euros depend on what treatment has been given each year. • Prior authorisations have mainly been granted for the care of pregnancy, childbirth, eye disease and cancer. Most prior authorisations have been granted for treatment in Estonia, followed by Sweden. • More information: kela.fi/sairaanhoito-kansainvalisissa-tilanteissa-hoitoon-hakeutuminen-ulkomaille *Refers to the year when public health care has paid Kela the costs of treatment covered by the prior authorisation. The patient living in Finland has received the treatment abroad earlier, possibly the preceding year. Source: Kela 7
  8. 8. 6. Amounts Kela has invoiced EU and EEA countries and Switzerland for treatment provided in Finland on the basis of prior authorisation (€) Year Amount invoiced by Kela, €* 2017 326,055 2016 426,841 2015 429,564 2014 383,260 • Another EU or EEA country or Switzerland may grant a patient prior authorisation for treatment to be provided in Finland. • If a customer has prior authorisation, they pay the client fee for treatment in Finnish public health care. The state that granted the prior authorisation is responsible for the actual costs of treatment. • If a patient has received treatment in Finland with prior authorisation, public health care invoices the actual treatment costs to Kela. Kela pays the costs and invoices them to the state that granted the prior authorisation. • There is no information on the numbers of patients that have come to Finland with prior authorisation. Finland charges Estonia and Sweden the most on the basis of prior authorisation. • More information: kela.fi/sairaanhoito-kansainvalisissa-tilanteissa-kuka-maksaa-hoitosi *Refers to the year when Kela has invoiced the costs of seeking treatment in Finland from abroad. The treatment has been given to the patient from abroad earlier, possibly the preceding year. Source: Kela 8
  9. 9. 7. State reimbursement to public health care for treatment costs State reimbursement for public health care Year Number of invoices Reimbursements € 2017 27,663 21.04 million 2016 21,340 17.82 million 2015 22,744 16.57 million 2014 10,876 8.49 million 2013 15,695 10.75 million • The purpose of state reimbursement is to compensate public healthcare for treatment costs when treatment has been given to persons • who do not have a municipality of residence in Finland • who have a municipality of residence in Finland but whose healthcare and maternity costs are the responsibility of another state that applies EU legislation • Kela pays the state reimbursement to public healthcare providers four times a year on the basis of applications. • More information: kela.fi/yhteistyokumppanit-hoitokustannusten-valtion-korvaus Source: Kela 9
  10. 10. 8. Debts and receivables for medical costs between Finland and other EU and EEA states and Switzerland Year Number of invoices sent by Finland Reimbursements received, € million Number of invoices received by Finland Reimbursements paid, € million 2017 8831 4,79 M€ 30 754 8,85 M€ 2016 7 173 6,00 M€ 33 193 13,45 M€ 2015 7 080 3,74 M€ 24 270 16,67 M€ 2014 4 109 5,00 M€ 15 673 10,90 M€ 2013 6 991 7,80 M€ 32 846 16,8 M€ • The table shows the costs that EU and EEA states and Switzerland charge for medical care given to people. The cost include 1) actual medical care costs and 2) flat-rate amounts (calculated costs). • Flat-rate amounts may be charged for a person permanently residing abroad whose medical costs are covered by a state other than the state of residence. For example, a Finnish pensioner residing in Spain who receives a pension only from Finland and has moved permanently to Spain. Finland pays Spain €XX/month/person in reimbursements for medical care for this pensioner. • Reimbursements for treatment costs are paid directly between the states. The patient pays the local client fee but not the actual treatment costs. • The costs are invoiced at a different time to when the actual treatment is given. The patient may have received the treatment several years earlier. • More information: kela.fi/sairaanhoito-kansainvalisissa-tilanteissa-kuka-maksaa-hoitosi Source: Kela 10
  11. 11. 9. Numbers of European Health Insurance Cards (EHIC) issued by Kela Year Number of European Health Insurance Cards 2017 1,869,780 2016 1,755,847 2015 1,578,400 2014 1,462,950 2013 1,334,155 • Kela issues a European Health Insurance Card to people who have health insurance in Finland or whose treatment costs are the responsibility of Finland. • The card is applied for from Kela, and it is valid for two years at a time. If the justifications for issuing the card are met, a new card is mailed automatically when it has been ordered once. • With the card, a patient can receive necessary treatment in EU and ETA countries and in Switzerland during a temporary stay, for example, when travelling. For the patient, the treatment costs the amount of the local client fee. • More information: kela.fi/eurooppalainen-sairaanhoitokortti Source: Kela 11
  12. 12. 10. Contact Point for Cross-Border Healthcare in Finland • The Contact Point for Cross-Border Healthcare provides advice on using health services in Finland and abroad. • Each EU country has a contact point. In Finland, the contact point is located within Kela. • The contact point provides service as follows: – Website www.choosehealthcare.fi www.vardenhetsval.fi www.hoitopaikanvalinta.fi www.saame.hoitopaikanvalinta.fi www.viittomakieli.hoitopaikanvalinta.fi www.teckensprak.hoitopaikanvalinta.fi – E-mail: yhteyspiste(at)kela.fi – Twitter: @rajayhteyspiste 12

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