AOS changes are coming

Changes in the financing of specialized services are to be an antidote to the growing queues to doctors, Health Minister Izabela Leszczyna said several times in January, even stressing that she is prioritizing the project. The Fund is working on the changes, and the specifics are expected to be published very soon. The idea is to eliminate the situation in which the same patient, with the same health problem, visits the AOS clinic not once or twice a year, but even several times each, which obviously blocks the admissions of first-time patients. The Health Ministry wants patients diagnosed and with a set therapy to be "taken over" by primary care clinics - and wants to force AOS clinics to open up to first-time patients with a financial incentive. It's the right move insofar as, in the vast majority of cases, there is no reason for a patient with a stabilized chronic disease to visit a specialist even once a year.

The Health Ministry also consistently reminds us that the removal of limits has not translated in any way into a reduction in queues - AOS expenditures, for non-limited services, have increased (the "non-limited overexpenditures" alone amount to about one billion zlotys per quarter in 2024), and queues have not decreased, some have even increased. Therefore, now in order to maintain the current level of funding, AOS clinics will have to accept at least a certain percentage of first-time patients. So their costs will increase - first-time visits are associated with the tests necessary for diagnosis and selection of therapy. If they do not reach the limit set by the Fund, funding will be reduced - but, at least for the time being, the restoration of capping of AOS services is not under consideration. Most likely, the percentage of first-time patients will be determined separately for each specialty. It is also possible that there will be specialties that will not be covered by the degressive rate - oncology, among others, is mentioned in this context.

During the panel that opened this year's "Priorities," Jakub Adamski of the Office of the Patient Ombudsman stressed that while the planned changes in AOS are understandable and beneficial for patients - because they will unlock access for those who are currently stuck in the longest queues - at the same time it must be remembered that they will affect patients accustomed to treatment at specialists, and therefore this group needs to be warned in advance and properly communicated the sense of the operation being performed.