CNAS changes the financing paradigm: hospitals will receive money based on performance

Financing hospitals based on performance criteria is an essential step for the recovery of the Romanian medical system, said the president of the National Health Insurance House (CNAS), Horaţiu-Remus Moldovan, during a videoconference with the directors of the 43 county health insurance houses. According to a CNAS press release, the legislative amendments recently adopted by Parliament and validated by the Constitutional Court create the necessary framework for a fair and efficient redistribution of funds in the healthcare system. Hospitals, which represent the "largest consumer of funds", will be evaluated based on performance, the quality of the medical act and the efficiency of resource use.

• Hospitals will have to reorganize

According to CNAS, each medical unit will have to analyze its internal structure and decide which departments will be kept, resized or reorganized, depending on the occupancy rate and the real needs of the community. In the case of hospitals with underutilized departments, the proposed solution is the establishment of consortia, through which several units will be able to collaborate to provide complete medical services to patients in a certain area. "Hospitals provide vital services, but the reality is that, in some places, their structures have remained unchanged for 50 years and no longer correspond to the current needs of people. Romanians deserve functional hospitals, with staff who understand what a medical act done with responsibility and respect for the patient means," Moldovan stressed.

He specified that the performance indicators will track the real efficiency of medical activities, the occupancy rate of beds, waiting times and treatment results. "It is not normal for some doctors to operate emergencies all night, while other lines of duty exist only out of habit,” added the CNAS president.

• Message for hospital managers: "Get out of the administrative comfort zone”

At the end of the meeting, Horaţiu-Remus Moldovan asked the directors of the county hospitals to send a clear message to hospital managers: the reform must be applied with courage and responsibility. "CNAS, through the county hospitals, will provide support to every hospital that wants to become more efficient. We all want fairness and responsibility in spending public money, which means getting out of the administrative comfort zone and finding fair solutions for patients - including through rigorous negotiation of contracts for sanitary materials, equipment and consumables,” said Moldovan. He added that the goal of the reform is not to close hospitals, but to eliminate waste and improve medical services. "Nobody wants to close hospitals, but we cannot tolerate waste either!", pointed out the president of CNAS. The new approach to hospital financing marks the beginning of a stage in which medical performance, transparency and accountability become the main criteria for allocating resources. By applying these principles, the authorities aim to balance access to health services and increase patients' trust in the public system.