Unexpected data: some medical institutions got poorer, others got richer

This is demonstrated by the financial results of personal health care institutions for the first half of 2020, which were presented by Simona Adamkevičiūtė, director of the Department of Economics of the State Health Insurance Fund (VLK), at the meeting of the Committee on Affairs Seimas Health on Wednesday.

S. Adamkevičiūtė warned that the results are still intermediate, because VLK has not yet received a financial activity report from Klaipėda Seamen’s Hospital (KJL), which suffered a cyber attack. The attack damaged the hospital’s servers that ran accounting and payroll systems. However, the specialist doubted that the later data obtained from KJL had a significant effect on the intermediate results, which are clearly improving.

Revenue increased 10 percent

According to S. Adamkevičiūtė, in the first half of the year the income of public medical institutions amounted to 813 million. and increased by 10 percent to 78 million euros. Most of this growth was due to the income of the medical institutions of the Compulsory Health Insurance Fund (PSDF), which amounted to 77 million. euros.

“It is 10 to 12 percent. Revenue growth is higher than costs. This resulted in a positive financial result. The costs of public medical institutions amounted to 781 million. It increased by 63 million euros, a 8% increase. And the increase in the cost of services provided by PSDF was 59 million, or 9%, “explained the specialist.

Salaries and social security costs grew faster, according to provisional results. The remaining institutional costs for medical supplies or utilities did not increase. While some institutions resulted in additional costs for medical supplies or utilities, others did not because they were not intensive. Therefore, the overall result of the Lithuanian medical institutions does not show an increase in these costs. The increase is only in the cost group “Disinfectants and other solutions”.

Most of the costs is salary.

According to S. Adamkevičiūtė, salary costs increased in all groups of institutions, but these growth rates are different.

“We see that the growth in the university hospitals was 22 percent. The biggest increase was in the salary costs of the ambulance stations (GMP): 33 percent, in the nursing hospitals it was 29 percent,” said a VLK specialist.

Antanas Matulas, a member of the Seimas Health Affairs Committee, was surprised by the fact that, as the semi-annual report on financial activity shows, the pay gap between large and small hospitals continues to widen.

“280 million were destined for salaries to university and republican hospitals. The amount allocated to all other medical institutions – regional, district hospitals and polyclinics – is about 150 million euros and increased by 22%. and grew 12 percent. How could other hospitals increase their salaries by the same percentage indicated by the Ministry of Health (SAM), if it is obvious that their salary fund has doubled? Asked a member of the Seimas.

Kristina Garuolienė, Deputy Minister of Health, responded: “All financiers would say that it would be inappropriate to judge the financial situation of a particular institution from the semi-annual results. We have the data we have.

As for the first half of the year, we must understand that medical institutions worked very differently: some worked at a very high intensity, had a large flow of patients, had to pay a lot of overtime surcharges to nurses, doctors. Other institutions operated at a lower capacity. This, of course, is reflected in the financial result. “

The overall financial result is improving

Reviewing separate groups of medical institutions, S. Adamkevičiūtė stated: the overall financial result is improving. For example, in the first half of 2019, up to 85 institutions had ended with a negative financial result, and in the first half of 2020, only 51 institutions, that is, 34 institutions less.

“In 2017, the total total result of all medical institutions was positive, plus 2.5 million. Euros. In 2018, it grew to more than 10 million. Euros. A year ago, there were 12 million. And now it is more than double , with almost € 30 million Euros Of course we do not have data from KJL, but I think that this result should be positive and further increase this overall result.

As of June 30, 2019, the overall result for the regions, districts and groups of nursing hospitals was negative. This semester is positive. Only the total result of the GMP stations is negative ”, pointed out the VLK specialist.

Santara clinics suffered losses

In the first half of 2019, there were two institutions in the group of university hospitals that had a negative financial result. These are the Žalgiris Clinic and the National Cancer Institute. Now the financial results of these institutions are positive.

Currently, only the Santara clinics have a negative economic result in the group of university hospitals.

“The deterioration in the economic performance of the Santara clinics was due to two reasons: additional salary supplements due to the increase in the workload. Other expenses also increased at this institution. For example, the cost of laboratory tests increased by 60% and the institution spent more than 7 times on disinfectant solutions compared to 2019. other expenses in the first half of the year. Other expenses grew 21 percent.

Those additional covid-related purchases have yet to be funded for the Santara clinics. They will be funded in the future. The financial result should improve in the future ”, predicted S. Adamkevičiūtė.

The situation in hospitals in the Republic, regions and districts has improved

The economic results also improved in the group of hospitals in the republic. If in 2019 there were 4 hospitals in the republic that had a negative financial result. This year, only one Republican Hospital in Klaipeda remained. But, as S. Adamkevičiūtė observed, the negative result from this medical institution is no worse than a year ago and is even slightly lower.

In the group of regional hospitals, 7 hospitals had a negative financial result in the first half of 2019. Now they all have a positive financial result and there is no one who has a negative financial result.

In the group of district hospitals, the situation also improved. In the first half of 2019, there were 27 institutions with a negative financial result, now only nine remain.

Vilnius GMP Station Highlights

The general deterioration of financial indicators is observed in the group of GMP stations. If in the first half of 2019 8 GMP stations had a negative financial result in this group, this year there are already 10. However, this negative result is neither great nor significant. Only the Vilnius GMP station stands out.

“According to the explanatory note in the financial report of the Vilnius GMP station, the institution indicates that it has acquired additional protective medical equipment. It also rented additional premises and additional equipment to ensure additional staff safety. These additional costs led to a deterioration in financial results.

Costs increased significantly and additional salary costs were calculated for employees due to deviations from normal working conditions, ”explained the VLK specialist.

According to S. Adamkevičiūtė, the negative financial result of the GMP stations was also determined by the increase in other costs: the costs of medical supplies doubled, disinfectants and other costs increased nine times, and transportation costs increased by up to one 11% compared to the same period of the previous year.

The negative result is negligible

In the group of nursing hospitals, 6 treatment institutions had a negative result. Now one and that negative result is negligible compared to the previous year, according to S. Adamkevičiūtė, negligible.

There were none in the group of polyclinics from a year ago that had a negative financial result. Now there are 4 institutions, but that negative financial result is also very insignificant: 0.1 percent. up to 4 percent. institutions income.

There is also a positive trend in the group of Primary Care Centers (PSPC). In the first half of last year, 30 medical institutions had a negative financial result, now – 25.

Financial liabilities increased by almost a third

According to S. Adamkevičiūtė, the financial obligations of medical institutions have increased significantly this year, up to 27 percent. This may involve purchasing additional equipment.

The growth limit of financial liabilities is up to 25%. it is considered safe green, 25 to 30 percent. – yellowish and more than 30% considered critical.

So far, according to the expert, despite the increase in financial commitments, the critical threshold has not been exceeded.

Why did the income grow?

According to S. Adamkevičiūtė, the main reason that revenues grew faster than expenses was that, although the PSDF lost part of the revenues due to quarantine, one twelfth of the contracted amount was still paid to medical institutions. And the institutions that provided the over-contracted services were a guarantee that they would also be paid separately.

The specialist added that in addition to the income received from the PSDF, the medical institutions also received financing from other sources: 30 million. 6 million euros received from the state budget. of the municipal budget. Medical institutions also receive support from international organizations, foreign countries and the EU. Another 18 million. 31 million euros in income from payment services. from other sources, such as 2% of the population. hospitals or support of legal persons.

The situation will get even better

The situation is likely to improve further in six months as SAM has committed an additional € 14 million to fund the costs of the quarantine. euros.

Raimonda Janonienė, Head of the Department of Planning and Strategic Management of SAM, said that today all the information on the costs incurred by medical institutions in the purchase of personal protective equipment, medical equipment or purchase of works and other needs to combat COVID-19.

“Institutions that were in the front line – covidium hospitals, their assigned institutions that assisted in the provision of these services, as well as institutions that provided fever clinics or GMP, will be reimbursed for all declared costs.” These processes are ongoing. The contracts are simply being drafted and drafted, and that financial mechanism will soon begin, as the Government has already allocated the necessary funds to finance the losses suffered by these agencies.

The financial situation of these institutions is very likely to change significantly by the end of the year. As for the Santara clinics, according to their reported costs, 3.8 million. it must reach the institutions for the costs they incur when purchasing various instruments. The situation will definitely improve significantly, “promised R. Janonienė.