A bid to streamline remuneration for services offered at hospitals under the national health scheme Gesy is underway with proposals from its operator, the health insurance organisation (HIO), already in their hands, its director said on Tuesday.

HIO Director Andreas Papaconstantinou, speaking on CyBC radio, said the new renumeration model would entail all hospital procedures.

“The logic in relation to fees is that they start from the same base, but will be differentiated on the basis of how the hospitals will meet certain quality criteria, as well as the percentage they will achieve in each quality criterion,” he said.

The system, designed to be an incentive to providers to take the initiative and review aspects of care they can improve, has been well received, he said.

One current discrepancy across hospitals is renumeration for births, compensation for which differs widely across various care providers. The proposal suggests equal renumeration for births across the board.

The good news for patients, is that the proposals include a “patient satisfaction” rating, given directly by patients upon discharge via email or a mobile app. Patients would respond to a questionnaire and rate the quality of care received for aspects including bedside manner, food quality, and the level of diligence with which doctors explain medical procedures and treatment options.

Initial base rates for all hospitals will be the same, however, each hospital can increase that rate by up to 25 per cent based on its score in the quality criteria.

Qualitative criteria concern, among others, the category that a hospital falls into on the basis of its infrastructure, e.g. intensive care unit, number of specialties, availability of specific infrastructure, accreditation, correct discharge filling and average age of patients.

The proposal has been in the hands of the hospitals since last Friday, and the HIO is now waiting for their positions to officially begin negotiations.

Papaconstantinou said he expects a new system to in operation by July 1.

Although the response has not been negative, Papaconstantinou said he expects the associations for private and small-to-medium hospitals to request clarifications of the criteria in upcoming days.

Hospitals are concerned about the total number of units for which they are entitled compensation. The units allocated correlate to the number of procedures carried out at any given hospital, and a large part of the negotiation is expected to centre around what happens when the maximum number of eligible procedures is exceeded.

For his part, Papaconstantinou said he hoped the new renumeration model would modernise healthcare on the island and introduce a minimum quality of care which patients could count on, no matter which hospital they were admitted to.

The director also said the system offers a way for state hospitals – also part of Gesy – to shake off the image that they were somehow ‘lesser than’ what, until now, have been called private hospitals. All hospitals, he said, are now part of the same system.