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When Kry opened the doors of its first fitness center in Stockholm, Regional Finance Counselor Irene Svenonius (M) was present.
– It’s very positive. In this way, we can reduce costs for Kry callers while also gaining information and control over the content of care, Irene Svenonius said at the time.
Reduced costs it would benefit from the fact that the region would now avoid being billed with so-called out-of-county compensation for video calls.
The so-called out-of-county compensation has been a hot topic in the digital care debate. Initially, digital actors could bill provincial councils more than SEK 2,000 for digital visits to doctors, something that DN had previously examined. Since then the compensation has decreased and is now 500 SEK.
The basic allowance today in the Stockholm Region for visits to doctors in a health center, regardless of whether it is digital or physical, is 260 SEK. But through a decision in the contracts committee in February, the compensation system was changed to benefit newly started health centers. Newly established health centers would now receive an additional 50 percent for each visit during the first 12 months, something Svenska Dagbladet wrote about previously.
“Since most of the compensation depends on how many people decide to sign up at the front desk, it can be difficult initially to monetize the business before you have created your own list,” the decision documents state.
Less than a month Following the decision on additional compensation, Kry CEO Erik Hjelmstedt signed an application from Digital Medical Supply Sweden AB, as the health care company itself is called, to open a health care center in Stockholm. The request was valid as of May 1, the same day that the new compensation took effect.
Kry CEO Erik Hjelmstedt.
Photo: Kry
The Left Party demanded the approval of its own proposal and lobbied for the region to develop and perform surgeries for GPs in the region where necessary. According to V, it was “naive” of the blue-green majority to propose a double compensation per visit for newly created businesses during the year “in the hope of attracting the market to new establishments to try to solve availability, instead of acting consciously and actively “.
To benefit of the facility allocation, the number of patients in the specific health center should not exceed 4,000 people. After Kry’s record-breaking patient list of 10,586 in a month, the vast majority – just over 10,000 – are listed on the Gallerian Health Center, which was the option that first appeared on the app. But it is also worth it that Kry has few patients included in her second health center, as they can receive the facility assignment there.
In addition to the facility allowance, health centers receive an additional payment if they help an unlisted patient, an additional SEK 190 per visit, an allowance that was introduced in 2019 to “stimulate clinics to receive people not listed or listed in another clinic. ” Today, about 9 percent of all Stockholm residents are not on the list.
This means that Kry can bill the region a total of SEK 580 for both digital and physical meetings with the doctors, if the patient is not listed, something that is confirmed by the Stockholm Region.
That’s SEK 80 more than when Kry received compensation outside the county.
The regional health advisor, Anna Starbrink (left), says that compensation has been requested from the new facility to facilitate the start-up of new health centers.
– One point of view that we have received is that it is difficult to start up new health centers without a large capital at the back, because you have to have many lists. This is a change that we are fully aware of, and I think it’s great that we now have new health centers and that Kry is establishing itself. It’s important that we stay away from these out-of-county benefits, says Starbrink, who denies that the compensation was introduced to benefit Kry.
Anna Starbrink (L), Regional Health Council.
Photo: Alexander Mahmoud
– No, not for Kry. I think it is good that they come here and settle, but it is not rigged for a specific company.
Was the compensation intended to be more than the SEK 500 it costs for an out-of-county visit?
– We have not had the compensation for medical visit, but this is for a limited period and that we would pay more initially is the decision itself, so it is clear that we were prepared for it. In the long term, it is good business for us that Kry and others stop billing out of the county and become part of our full range of care in the region.
The Social Democrats participated not in the February decision, and noted the importance of supporting the establishment of new health centers in areas where there is greatest need.
– We see that the establishment assignment reinforces a market logic. And it’s interesting now that it becomes more lucrative than out-of-county compensation, which in itself is a problem! Those who are most seriously ill and most in need of care are the most affected by the moderates who manipulate the system in this way, says Talla Alkurdi, Regional Councilor for the Opposition.
At the same time, S criticizes the large role in the compensation system in the Stockholm region that visitor compensation has and therefore can benefit simple and quick visits, currently around 40 percent.
Claes Nyberg, Kry’s Acting Press Manager, answers DN’s questions in an email:
What has supporting the new establishment meant to Kry?
“Like all new health centers in the region, we participated in supporting the establishment when we opened without listed patients. It was a prerequisite for us to be able to continue serving the large base of patients who come to us daily for care, but who are listed in other health centers, and receive compensation that covers the costs for these.
He requested to open a health center on May 1, the same day the support went into effect. Was the initial compensation a factor?
“No, we have wanted to establish ourselves in Stockholm for a long time, but it is from the moment we open on September 1 that we have the opportunity to receive the support of the new establishment.”
On the fact that digital tours can be even more expensive for the Stockholm region than with out-of-county compensation, Nyberg comments as follows:
“For the vast majority of patients who are included in our list or in another health center that we care for, we receive less compensation per visit to the doctor even with the support of the new facility, compared to the national agreement which is 500 SEK per visit “.
Lina-Maria Ellegård, an economics researcher at Lund University, says that Kry, like other online medical companies, has always been adept at finding loopholes in regulations.
– I do not mean that they are evil, but that they act rationally to maximize profits and use regulations to their advantage. The first example was using out-of-county compensation in a way that was not intended. That they were successful for so long was because SKR was incomprehensibly slow to react to this.
Read more: Krys health center receives criticism; new guidelines will now be developed
