Since July 1, 2022, psychologists-psychotherapists can bill basic insurance alone for services prescribed by a doctor. But the transition to this model (known as “prescription”) resulted in costs twice as high as expected, according to a report commissioned by the Federal Office of Public Health (FOPH) and published on Friday.
We remember that with the previous model (known as “delegation”), psychologists were only reimbursed by basic insurance if they practiced under the supervision of a doctor. Some complementary services also sometimes covered their services.
According to the FOPH’s still provisional calculations, the new model should generate costs of 700 to 750 million francs for 2023. That is 175 to 200 million more than with the old one. Problem: it’s twice as much as the Federal Council had estimated. In 2021, he estimated the additional cost at 100 million francs for basic insurance.
How can this difference be explained? The OFSP highlights demographic developments and the fact that part of the therapies previously paid for by patients or supplementary health insurance is now covered by basic insurance. That was planned.
What was not, was the difference in the hourly rates charged. Indeed, Berne initially thought that they would be the same as before. “However, analyzes show that more than half of the increase in costs observed in 2023 is due to a higher price,” notes the OFSP. This is due to the absence of a national-wide convention. This means that “provisional prices set at the cantonal level apply”, he laments.
A future evaluation will now have to detail the services transferred from supplementary insurance to basic insurance as well as the quality of care since July 2022.
