Kela proposes a personal doctor/personal nurse model as basis for reimbursement system

Kela views positively the new model for Kela reimbursements proposed by the Ministry of Social Affairs and Health, which the Ministry recently circulated for comments. However, Kela would like to see the proposed model developed further towards a designated personal doctor/personal nurse arrangement, which would ensure the continuity of care without significant additional cost.

The proposal for a new model for Kela reimbursements was recently circulated among the key parties for comments. Kela takes a largely positive view of the proposal, because it supports the provision of primary health services and improves access to general practitioners. With no limits on the number of GP consultations, the model also promotes the continuity of care.

Drafting of a new model for Kela reimbursements will continue during the current Government term.

“The reimbursements that Kela pays for treatment costs could be based on an arrangement that would put the focus on the continuity of the doctor-patient relationship”, says Outi Antila, Kela’s Director General. She adds that a personal nurse and possibly other members of a multiprofessional team could provide additional support.

Strong evidence for the benefits of continuity in the doctor-patient relationship

There is strong evidence in research for the benefits of a continuous doctor-patient relationship. When patients receive care from a dedicated GP, the quality of care is improved, there is a significant decline in mortality and morbidity, the overall demand for and costs of health services are reduced, and patient satisfaction goes up.

Adoption of a personal doctor/personal nurse model for Kela reimbursements, implemented as part of the cooperation with the wellbeing services counties, would ensure the continuity of care without significant additional cost. Residents of wellbeing services counties would also be able to choose a GP specialist/personal nurse pair from the private sector.

According to experts at Kela, a personal doctor/personal nurse model would create more equity in health services and be a cost-efficient way to reduce wait-times for treatment. Such a model would free up resources in the public healthcare system that could be allocated to those with the greatest need for services and multiprofessional help.

“I hope that a new reimbursement model can be created in close cooperation with the wellbeing services counties and the relevant organisations", Antila says.

Read more

Kela’s statement at lausuntopalvelu.fi (in Finnish)
Research blog: New model for Kela reimbursements focuses on continuity of care – could be based on a personal doctor/personal nurse arrangement (in Finnish)