Poland’s National Health Fund (NFZ) is reducing funding for medical tests from 100% to 40%, potentially leading to longer wait times for patients.
NFZ Funding Cuts Impact Diagnostic Testing
The National Health Fund (NFZ) is implementing cost-cutting measures by reducing funding for medical tests from full coverage to 40%. This change may result in fewer available appointments and a resurgence of patient queues.
The NFZ’s decision reverses policies implemented in 2021, which eliminated limits on specialist outpatient care, aiming to improve access to tests and doctors. The system is now returning to restrictions, albeit indirectly, through altered payment methods.
Hospitals Face Financial Strain
Hospitals and clinics must now determine if they can afford to cover the remaining 60% of the cost for tests performed beyond contracted limits. Waldemar Malinowski, President of the Polish Association of District Hospital Employers, stated that the 40% reimbursement rate is insufficient to cover labor costs, leading to potential appointment reductions.
Return of Queues and Patient Concerns
The new funding mechanism raises concerns about the effective reinstatement of waiting lists. Previously, patients could generally expect tests to be performed even if a facility exceeded its limit; this safety net is now disappearing.
Patient organizations are warning that this will lead to a practical return of queues. Wojciech Wiśniewski of the Polish Entrepreneurs Federation explains that the NFZ is in a difficult position, as nearly all of its expenses are fixed.
Impact on Oncology Patients and Diagnostics
While exemptions are in place for children and patients with oncology cards (DILO), obtaining a DILO card requires initial testing, creating a loophole. Delays in testing for suspected cancer cases could allow the disease to progress or metastasize.
The NFZ underestimated the demand for tests, with a shortfall of 1.43 million PLN for a single test type in the Małopolska region alone, indicating a nationwide funding gap.
Cuts Extend to Specialist Visits
The NFZ also plans to implement a similar 40% reimbursement rate for specialist outpatient visits (AOS) exceeding contracted limits. This is particularly concerning as AOS was already a heavily burdened segment of the healthcare system.
Between 2021 and 2025, the value of AOS services increased by 117%, while the number of services only rose by approximately 20%, indicating rising costs without a proportional increase in patient access.
NFZ Deficit and Future Restrictions
The root of the problem lies in the financial realities of the healthcare system. In 2026, the NFZ’s revenue is projected to be 217.4 billion PLN, with a deficit of 23 billion PLN. Rising costs, such as an 8.82% increase in minimum wages for healthcare workers, further exacerbate the situation.
Experts believe that these cuts are just the beginning. Even if the changes generate several billion PLN in savings, it will still be insufficient to address the scale of the deficit. The NFZ may introduce further restrictions, not necessarily labeled as limits, but noticeable to patients.
Key Diagnostic Tests Affected
The changes specifically target essential diagnostic tools like colonoscopies, CT scans, and MRIs, which are widely used for detecting chronic diseases and cancers, and are increasingly in demand due to an aging population. Access to these tests had increased after the removal of limits in 2021.
Delayed Diagnosis: A Cost to Patient Health
Despite assurances from Prime Minister Donald Tusk that funds should prioritize accessibility and stability, the practical outcome may differ. The most significant impact on patients will be increased waiting times, affecting the speed of diagnosis and treatment effectiveness.
