ippta 11 th general meeting singapore 3rd may 2015 marc chevalier member board of directors...
TRANSCRIPT
IPPTA 11th General Meeting Singapore
3rd May 2015
Marc ChevalierMember Board of Directors physioswiss
Switzerland
2
Agenda
(1) Physiotherapy in Switzerland
(2) New tariffs for physiotherapy
(3) What happened since the last meeting?
3
Agenda
(1) Physiotherapy in Switzerland
(2) New tariffs for physiotherapy
(3) What happened since the last meeting?
4
Physiotherapy in Switzerland
Private prac-tice5727 53%
Hospit-als374235%
Special care homes, nursing homes,
etc.128412%
Number of physiotherapists (2010)
5
Men Women Total0
5
10
15
20
25
30
Treatment by a physiotherapistin the last 12 months (2012)
in % of the population
15-24 years25-34 years35-44 years45-54 years55-64 years65-74-jährig75+ years
Physiotherapy in Switzerland
6
Cost of health care by provider (2012)
Allgemeine KrankenhäuserPsychiatrische Kliniken RehabilitationsklinikenAndere SpezialklinikenPflegeheimeInstitutionen für Behinderte und andere InstitutionenenÄrzteZahnärztePhysiotherapeutenPsychotherapeutenSpitexdiensteAndere (paramed.)Medizinische LaborsAndere ambulante VersorgerApothekenDrogerienTherapeutische ApparateBundKantoneGemeindenKrankenversicherer (KVG)Unfallversicherer (UVG)IV-AHVPrivate Krankenversicherer (VVG)Organisationen ohne Erwerbscharakter
1.2%
Physiotherapy in Switzerland
7
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
1.1%
1.2%
1.3%
1.4%
300
400
500
600
700
800
900
Costs of physiotherapy
in %
of t
otal
cos
ts fo
r hea
lth
care
in m
illio
n C
HF
Physiotherapy in Switzerland
8
Who pays for physiotherapy?
Health in-surances
68%
Accidentinsurances
14%
Disability insurance
2% Patient16%
(2012)
9
Subsequent remarks only valid for health insurances
Health insur-ances68%
(2012)
10
Health care: Dominated by provinces
11
Tariffs in Switzerland
• Compensation is based on a tariff structure (what is paid with how many points) and a tariff agreement (how much is paid per point)
• The tariff structure is the same all over Switzerland. Tariff agreements are determined for each province separately.
• Example:
Structure Agreement
Province
Treatment Taxpoints
Value Compensation
Zurich „Standard“ 48 1.11 CHF
48 x 1.11 CHF
Grisons „Standard“ 48 0.94 CHF
48 x 0.94 CHF
12
Agenda
(1) Physiotherapy in Switzerland
(2) New tariffs for physiotherapy
(3) What happened since the last meeting?
(4) WCPT Congress 2019
13
16 years without change of the tariff
19
98
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
20
14
2015
16 1710 11 12 13 14 154 5 6 7 8 9Years without
change of the tariff0 1 2 3
appeal to the Federal Administrative Court (40 % of the insurer)
negotiations at the provincial level
decision by the Swiss government concerning the calculation basis
negotiations at the national level
discussions at the national level
negotiations at the provincial level
collective agreement is terminated
negotiations at the national level
negotiations at the national level (60% of the insurer)
imposition of tariffs by the provinces
appeal to the Federal Administrative Court (60 % of the insurer)
collective agreement with all insurances
14
How tariffs are established
1) Primacy of negotiation
2) Imposition of tariffs by the 26 provinces
3) Decisions by Federal Administrative Court
15
Partial solution
• For 60% of the insurers: Negotiations were partly successful Tariff agreement was made Insurers compensate about 50% of the
inflation
• For 40% of the insurers: Negotiations were not successful Insurers propose to compensate about 25%
of the inflation that is not acceptable
Imposition of tariffs by the 26 provinces
16
Contract with 2851 pages
17
Agenda
(1) Physiotherapy in Switzerland
(2) New tariffs for physiotherapy
(3) What happened since the last meeting?
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Public campaign: 2014
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Public campaign: 2014
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Public campaign: 2014
The insurance initiated legal proceedings for unfair advertising …
… but clearly lost the case. The public campaign was considered for being a political campaign.
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2015: New tariff structure is negoiated
22
Agenda
(1) Physiotherapy in Switzerland
(2) New tariffs for physiotherapy
(3) What happened since the last meeting?
Thank you for your attention!