Document Ordinance on the reform in the sanitary field, published by the Ministry of Health. What are the “strategic hospitals” and how the money will be divided

The Ministry of Health has put into public debate the draft emergency ordinance by which the reform of the ways operate, as well as new mechanisms for evaluating managers. Also, the category of “strategic hospitals” is introduced, which will benefit from special financing mechanisms.

“Respect for patients, dignity for medical staff, responsibility for hospitals-an absolutely necessary reform, put in decision-making transparency (…) It is not about austerity, but about the efficiency of resources and about a more functional, more transparent system,” says in a post on the Facebook account of the Ministry of Health.

The ministry indicates multiple directions of system reforming:

• Medical Consorti for Better Services: “Hospitals will be able to associate with each other for common medical activities, research, investments, but also medicines and equipment acquisition. It means more efficiently used resources and better services for patients, without unnecessary competitions.”
• Managers evaluated on performance: “We introduce clear management criteria, relevant performance indicators and a complete rethink of the way the competition is organized. The managers will conclude contracts of maximum 4 years, evaluated annually on these clear indicators. If they do not reach their goals, the contracts cease.
• Section chiefs with clear duties and responsibility: “Heads of section, laboratory or medical services will have administration contracts with annual evaluation.”
• More affordable family offices and a consolidated role in the system: “Family medicine offices can set up at most two working points, if the requesting doctor provides a fractional program of at least 5 hours per week, in his basic norm or over it. In addition, from 2026, the financing of family doctors will be based on the services actually granted to patients – 80% payment on service and only 20% payment per capita.”
• Development of specialized ambulatory: “The value of the point in the ambulatory increases to 6.5 lei from October 1 and to 8 lei from January 1. We invest directly in more accessible diagnostic and treatment services, so that the medical problems are solved quickly, without unnecessary urgency.”
• European health card with extended validity: “We extend the validity of cards 10 years after issuing for pensioners over 65, respectively for children until the age of 18.”
• Transparent and performance -based financing for hospitals

Regarding the last point, the Ministry of Health states that the allocation of funds to hospitals will be made on a methodology that will take into account several criteria:

• the share of personnel expenses in the total of the hospital's expenses;
• the share of the financial influences in the revenues of the hospital from the contract with the Health Insurance House;
• the share of financial influences in the total wage expenses of the hospital;
• Indicators of activity and medical performance, such as the volume and complexity of the services offered, the degree of use of the capacity of the hospital and the efficiency of the use of resources;
• Reporting the amounts allocated to the financial availability of the fund and to the strategic priorities established for the financing of the health system.

Also, a new category of hospitals will be created, that of “strategic” hospitals.

“These are units with complex activity or regional/national role, including with national health programs, which will benefit from special funds allocation. The purpose is for these hospitals to receive financing correlated with the complexity of the activity and with the real needs of the patients, thus ensuring quality services for complex or critical cases,” the source said.