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Country profiles of health system responses to the crisis | Romania
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Salaries and motivation of health sector workers
• Salary reductions of hospital physicians and other hospital personnel by
25% (2010), which subsequently rose again to 2010 levels in 2012.
• Recruitment freeze across all public sectors, including the health sector
(since 2010).
• In 2009–2011, the point value base on which GPs are reimbursed
decreased as per the framework contract, which stipulated that any
fluctuation in the income of the Health Insurance Fund can be reflected
in the payment level of the primary care. Funding improved in 2012,
increasing by 15% compared with the previous year through an increase
in the value of points awarded for services rendered.
• A new system of GP payment (reducing the per capita component of GP revenue
in favour of FFS linked with some performance evaluation) and a limitation
of number of hours worked per week was proposed as part of a revised GP
framework contract in 2010; it was rejected by GPs and was revised in 2011.
The framework contract for 2011–2012 changed the structure of GP payment:
50% per capita (70% in 2010) and 50% FFS (30% in 2010).
Payment to providers
• The Ministry of Health adopted a new classification of hospitals into
five categories; the financing of hospitals depends on their classification
(2011).
Overhead costs: restructuring the Ministry of Health and purchasing agencies
• Increased accountability in the management of hospitals transferred to local
government as part of an ongoing process of decentralization (2011).
• A plan announced to integrate the Health Insurance House of Transport
Workers into the National Health Insurance House (2012). The hospitals
owned by the Ministry of Transportation (mainly by the railway) will be
subordinated to local authorities.
• The Ministry of Health plans to centralize the procurement of drugs and
medical devices for hospitals in its network (2013).
Provider infrastructure and capital investment
• Introduction of new patient electronic record information system and an
“insurer card” planned in order to increase efficiency and reduce bureaucracy
(2010). In 2013, the electronic insurer card and electronic prescription
became compulsory after a pilot project in one county in 2012.
• The Ministry of Health announced the merger of 111 hospitals, with 69
hospitals set to be converted into nursing homes for the elderly (2011).