Eopyy.gov.gr: Difference between revisions
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EOPYY (National Organization for the Provision of Health Services) is the main public health insurance organization in Greece, established in 2011 to manage a unified health insurance fund and act as the sole purchaser of publicly funded health services. Here are the key aspects of EOPYY: | |||
== Organization and Governance == | |||
- EOPYY operates under the supervision of the Ministry of Health as a self-governing public entity. | |||
- It functions as a monopsony, being the sole purchaser of health services for over 95% of the Greek population. | |||
- EOPYY is responsible for negotiating, contracting, and remunerating both public and private healthcare providers. | |||
== Key Responsibilities == | |||
- Manages the unified health insurance fund | |||
- Provides a comprehensive health benefits package through the Unified Health Benefits Regulation (EKPY) | |||
- Contracts with public healthcare providers (PEDY primary care networks and ESY hospitals) and private providers | |||
- Sets preconditions for contractual commitments with healthcare providers | |||
- Reimburses healthcare costs for insured individuals | |||
== Health Services Network == | |||
- Public providers: PEDY (primary care networks) and ESY (public hospitals) | |||
- EOPYY-contracted private providers: doctors, clinics, diagnostic laboratories, etc. | |||
- Offers primary, ambulatory, and hospital care services | |||
== Reimbursement and Pricing == | |||
- Uses a system of third-party payments with regulated patient co-payments | |||
- Reimburses contracted providers based on negotiated contracts, insurance prices, or state tariff lists | |||
- Hospital inpatient care is reimbursed using KENs (equivalent to Diagnostic-Related Groups) | |||
- Publishes reimbursement tariffs and contracted health professionals on its website | |||
== Patient Access and Benefits == | |||
- Insured individuals have access to a unified health benefits package | |||
- Services are provided through public and EOPYY-contracted private providers | |||
- Co-payments vary depending on the type of service and provider affiliation | |||
- Public facilities generally have no co-payment requirement for the EOPYY health benefits package | |||
== | == International Role == | ||
- Acts as the Greek liaison body for reimbursement of sickness benefits under EU Regulation 883/2004 | |||
- Serves as the competent institution for place of stay or residence in cross-border healthcare | |||
- Member of the European Healthcare Fraud and Corruption Network (EHFCN) | |||
== E-services and Tools == | |||
- Operates an e-prescription system for monitoring pharmaceutical consumption and referrals | |||
- Provides e-tools for accessing information on benefits, reimbursement tariffs, and contracted providers | |||
- Implements the e-disbursement initiative (e-DAPY) for services, costs, and administrative functions of private providers | |||
== Challenges and Reforms == | |||
- Established as part of major structural reforms in the Greek healthcare system | |||
- Aims to improve efficiency, transparency, and cost control in healthcare provision | |||
- Faces ongoing challenges in managing healthcare costs and ensuring access to services | |||
EOPYY plays a central role in the Greek healthcare system, aiming to provide comprehensive health coverage while managing costs and improving efficiency in healthcare delivery. | |||
Latest revision as of 22:00, 9 March 2025
Eopyy.gov.gr[edit | edit source]
EOPYY (National Organization for the Provision of Health Services) is the main public health insurance organization in Greece, established in 2011 to manage a unified health insurance fund and act as the sole purchaser of publicly funded health services. Here are the key aspects of EOPYY:
Organization and Governance[edit | edit source]
- EOPYY operates under the supervision of the Ministry of Health as a self-governing public entity. - It functions as a monopsony, being the sole purchaser of health services for over 95% of the Greek population. - EOPYY is responsible for negotiating, contracting, and remunerating both public and private healthcare providers.
Key Responsibilities[edit | edit source]
- Manages the unified health insurance fund - Provides a comprehensive health benefits package through the Unified Health Benefits Regulation (EKPY) - Contracts with public healthcare providers (PEDY primary care networks and ESY hospitals) and private providers - Sets preconditions for contractual commitments with healthcare providers - Reimburses healthcare costs for insured individuals
Health Services Network[edit | edit source]
- Public providers: PEDY (primary care networks) and ESY (public hospitals) - EOPYY-contracted private providers: doctors, clinics, diagnostic laboratories, etc. - Offers primary, ambulatory, and hospital care services
Reimbursement and Pricing[edit | edit source]
- Uses a system of third-party payments with regulated patient co-payments - Reimburses contracted providers based on negotiated contracts, insurance prices, or state tariff lists - Hospital inpatient care is reimbursed using KENs (equivalent to Diagnostic-Related Groups) - Publishes reimbursement tariffs and contracted health professionals on its website
Patient Access and Benefits[edit | edit source]
- Insured individuals have access to a unified health benefits package - Services are provided through public and EOPYY-contracted private providers - Co-payments vary depending on the type of service and provider affiliation - Public facilities generally have no co-payment requirement for the EOPYY health benefits package
International Role[edit | edit source]
- Acts as the Greek liaison body for reimbursement of sickness benefits under EU Regulation 883/2004 - Serves as the competent institution for place of stay or residence in cross-border healthcare - Member of the European Healthcare Fraud and Corruption Network (EHFCN)
E-services and Tools[edit | edit source]
- Operates an e-prescription system for monitoring pharmaceutical consumption and referrals - Provides e-tools for accessing information on benefits, reimbursement tariffs, and contracted providers - Implements the e-disbursement initiative (e-DAPY) for services, costs, and administrative functions of private providers
Challenges and Reforms[edit | edit source]
- Established as part of major structural reforms in the Greek healthcare system - Aims to improve efficiency, transparency, and cost control in healthcare provision - Faces ongoing challenges in managing healthcare costs and ensuring access to services
EOPYY plays a central role in the Greek healthcare system, aiming to provide comprehensive health coverage while managing costs and improving efficiency in healthcare delivery.