Poland’s National Health Fund (NFZ) will implement new regulations for clinics on January 20, 2026, offering 6,000-9,000 zł incentives and imposing penalties for coordinated care compliance.
NFZ Changes Rules for Primary Care Clinics Starting January 20, 2026
New rules introduced by the National Health Fund aim to force clinics to actually implement coordinated care rather than just formally declaring it. Many facilities had signed agreements but in practice covered only a small fraction of patients with this model.
Financial Incentives of 6,000-9,000 zł for Coordinated Care
From January 2026, clinics can receive additional funds if they actually provide coordinated care to most of their adult patients. The mechanism is simple but challenging in practice. For small facilities, this often equals the salary of an additional employee. For larger ones, it represents money that can determine the profitability of the entire model.
Why NFZ Is Tightening Regulations in 2026
Data that reached decision-makers was concerning for the Fund. A significant number of clinics declared coordinated care but in practice covered only a symbolic percentage of patients. Sometimes facilities collected funds for a coordinator without providing actual services. The new model aims to cut through this. From now on, money should follow actual work with patients, not just presence in the system.
NFZ Penalties for Primary Care Clinics
Where there are incentives, there are also sanctions. And here NFZ left no room for interpretation. If a clinic fails to provide coordinated care services for three consecutive months or does so to a minimal extent, it loses not only additional incentives. It also loses: the right to additional payments, the right to bonuses, and the right to participate in new programs. For some facilities, this means several thousand zł less per quarter.
What the Changes in Primary Care Mean for Patients
Although the change concerns financing, patients will feel its effects indirectly but very concretely. In practice, this means: more tests and “hand-holding” through the healthcare process, better coordination between different specialists, and reduced risk of “getting lost” between tests and doctors. Coordinated care includes patients with heart disease, diabetes, lung diseases, hormonal disorders, and kidney diseases. These are the groups where NFZ expects the greatest qualitative change.
The Role of the Coordinator in Coordinated Care
One of the key elements of the reform is the role of the coordinator. Until now, this function often existed mainly in documents. Now NFZ clearly signals: the coordinator must act or there will be no money. For the patient, this means easier scheduling of appointments, better information about the next stages of treatment, and less risk of “getting lost” between tests and doctors.
Some Clinics Will Gain, Others Will Lose
The new model rewards active providers and penalizes passive ones. Clinics that already work intensively with chronically ill patients have a chance to gain. Those that treated coordinated care as a formality face a choice: change their work approach or reconcile themselves to losing money. For patients, this may mean differences between clinics – even in the same locality. Although the regulations are already in effect, the real effects will be visible in the coming months. That’s when it will become clear which clinics will adapt to the new rules and which will begin limiting the scope of services.
