Differing compensation systems skew competition between private digital healthcare providers and healthcare centres

This is the conclusion of the Swedish Competition Authority in the report The impact of private digital healthcare services on competition in primary care.

In the report, the Swedish Competition Authority investigates how private digital healthcare services impact on competition in primary care. The report focuses on digital healthcare visits financed through so-called out-of-county compensation, which is the compensation paid out when a patient visits a healthcare centre outside their home region, meaning that there is no contractual relationship between the healthcare provider and the home region.

The Swedish Competition Authority concludes that private digital healthcare services and healthcare centres operate on the same market. They target the same patients and are financed within the framework of the regions’ choice-of-care system. Despite this, they have two radically different compensation systems. The report shows that a healthcare centre offering digital healthcare services to its listed patients will get less compensation than a private digital healthcare service will get through out-of-county compensation if the same patient uses that service instead.

‘The system with out-of-county compensation means that there is not competition on equal terms between healthcare centres in the choice-of-care systems and private digital healthcare providers that receive out-of-county compensation. Therefore, the system with out-of-county compensation should be reviewed’, says Rikard Jermsten, Director-General of the Swedish Competition Authority.

As there is no contractual relationship between the home region and the private digital healthcare providers, there are limited possibilities to devise services that require the exchange of digital information.

‘Out-of-county compensation means that regions are paying for services they have not ordered. The lack of a contractual relationship also means that the regions cannot influence the contents of the digital services or systematically follow up on which services are provided’, says Rikard Jermsten.

As part of the work with the report, the Swedish Competition Authority has performed a survey among operations managers at healthcare centres. The survey results show that the healthcare centre managers also see benefits of private digital healthcare services. For instance, six of ten healthcare centre managers feel that private digital healthcare services have contributed to patients and healthcare staff becoming more at ease with digital healthcare services.

Private digital healthcare services have also driven the development towards increased digitalization within healthcare. The answers to the Swedish Competition Authority’s survey shows, among other things, that more than eight of ten healthcare centre managers (84 percent) feel that private digital healthcare services have stimulated the development of digital healthcare services among other healthcare providers.

Marie Strömberg Lindvall, press officer, +46 (0)76-542 15 92, marie.stromberglindvall@kkv.se
Leif Nordqvist, project manager, +46(0)8 700 16 94, leif.nordqvist@kkv.se

Read the report: The impact of private digital healthcare services on competition in primary care (in Swedish with a Summary in English)