Agreement between private entities to bear the costs caused by the coronavirus in medical care. The car insurers have always paid an amount to private hospitals to cover the necessary expenses of its customers after suffering a car accident. However, the landscape has changed radically since the arrival of the pandemic , where the protocols to control the virus made medical care more expensive. Until now, private health was paying these extra costs, but from now on the car insurers will assume their share.
The signatories of that agreement signed in 2019 and valid until 2022 (the Spanish Private Health Alliance, the Spanish Union of Insurance and Reinsurance Entities, the Insurance Compensation Consortium and other regional associations of clinics , hospitals and outpatient care centers and rehabilitation) recognize the extra cost produced by the exceptional measures motivated by the coronavirus pandemic. That is why they have agreed to a new agreement that updates the previous one to the conditions that the health alert has provided.
The economic translation of this agreement is that private healthcare will be rewarded “by 4.9% over the agreed rate for one of the most frequent causes of admission, the Vertebral Spinal Module”, sources familiar with the negotiation explain to elEconomista . This fee was valued, for this year, at 715.69 euros and now 35 euros more will be paid for each admitted .
“The agreement now incorporates the coverage of the specific protocols that have had to be implemented in health centers against the virus and that include, among other measures, the performance of clinical laboratory diagnostic tests (PCR) to hospitalized patients, as well as the use of disposable individual protection material by professionals in the hospital and outpatient setting “, they explain from Aspe.
The negotiation, in addition, will not be limited to 2021, but will monopolize the entire pandemic. The tariff adaptation has been agreed retroactively, from March 14, 2020 to September 30, 2021, and can be extended fortnightly as long as the accumulated incidence data for 14 days (according to official data from the Ministry of Health) remains above of 50 cases. Only during the month of October (from the 6th of that month to November 4) the incidence was below the agreed margins and today the pandemic is rampant and with an incidence of more than 450 cases.
In Spain there is a framework agreement for health care derived from traffic accidents aimed specifically at private health centers. This is because every patient has the right to choose the center where they want to be treated for their injuries based on the options offered by their insurer. “For the clinics and health centers in charge of treating patients who have been victims of a traffic accident, it is a guarantee to be able to work under protocols agreed upon by all parties to, among all, offer the best possible care despite exceptional circumstances. of the pandemic “, says the secretary general of Aspe, Luis Mendicuti.
The figures show that private centers are the favorites for Spaniards when it comes to recovering from a traffic accident. Of the 580,978 annual accidents with injuries due to a hit with the car, 59% (340,860) are treated in hospitals without internment of the private health sector, compared to 41% of those treated in public health , according to data from the Vehicle Information File Policyholders (Fiva) and the Automobile Insurance Statistics (ESA) collected in a Unespa report.
One of the achievements of this Framework Agreement is the improvement in the unification of management, establishing objective criteria for assigning the payment of health care and informing the health centers of the insurance entity obliged to pay. Thus, health centers, insurance entities and the Insurance Compensation Consortium use the Management System for Health Benefits Payments in Automobile Claims. Thanks to this, the information exchange processes and the management of electronic billing of healthcare services are streamlined and simplified through automation.