title: The introduction of Greek Central Health Fund: Has the reform met its goal in the sector of Primary Health Care or is there a new model needed?
abstract: BACKGROUND
  The National Organization for Healthcare Provision (EOPYY) originates from the recent reform in Greek healthcare, aiming amidst economic predicament, at the rationalization of health expenditure and reactivation of the pivotal role of Primary Health Care (PHC). Health funding (public/private) mix is examined, alongside the role of pre-existing health insurance funds. The main pursuit of this paper is to evaluate whether EOPYY has met its goals.
  
  
  METHODS
  The article surveys for best practices in advanced health systems and similar sickness funds. The main benchmarks focus on PHC provision and providers' reimbursement. It then turns to an analysis of EOPYY, focusing on specific questions and searching the relevant databases. It compares the best practice examples to the EOPYY (alongside further developments set by new legislation in L 4238/14), revealing weaknesses relevant to non-integrated PHC network, unbalanced manpower, non-gatekeeping, under-financing and other funding problems caused by the current crisis. Finally, a new model of medical procedures cost accounting was tested in health centers.
  
  
  RESULTS
  An alternative operation of EOPYY functioning primarily as an insurer whereas its proprietary units are integrated with these of the NHS is proposed. The paper claims it is critical to revise the current induced demand favorable reimbursement system, via per capita payments for physicians combined with extra pay-for-performance payments, while cost accounting corroborates a prospective system for NHS's and EOPYY's units, under a combination of global budgets and Ambulatory Patient Groups (APGs)
  
  
  CONCLUSIONS
  Self-critical points on the limitations of results due to lack of adequate data (not) given by EOPYY are initially raised. Then the issue concerning the debate between 'copying' benchmarks and 'a la cart' selectively adopting and adapting best practices from wider experience is discussed, with preference to the latter. The idea of an 'a la cart' choice of international examples is proposed. The 'results' discussing EOPYY's dual function and induced-demand favorable reimbursement system are further critically examined. International experience shows evidence of effective alternatives, such as per capita and pay-for-performance payments for practicing doctors as well as per case reimbursement for health centers under global budget principles.
authors.forename: Nikos
authors.initials: N
authors.lastname: Polyzos
authors.forename: Stefanos
authors.initials: S
authors.lastname: Karakolias
authors.forename: Costas
authors.initials: C
authors.lastname: Dikeos
authors.forename: Mamas
authors.initials: M
authors.lastname: Theodorou
authors.forename: Catherine
authors.initials: C
authors.lastname: Kastanioti
authors.forename: Kalomira
authors.initials: K
authors.lastname: Mama
authors.forename: Periklis
authors.initials: P
authors.lastname: Polizoidis
authors.forename: Christoforos
authors.initials: C
authors.lastname: Skamnakis
authors.forename: Charalampos
authors.initials: C
authors.lastname: Tsairidis
authors.forename: Eleutherios
authors.initials: E
authors.lastname: Thireos
mesh_terms: D005376:Financial Management / Q000191:economics; D006040:Goals; D018166:Health Care Reform; D005102:Health Expenditures / Q000706:statistics & numerical data; D061889:Healthcare Financing; D006801:Humans; D007348:Insurance, Health / Q000191:economics; D011320:Primary Health Care / Q000191:economics*; D017149:Private Sector; D011446:Prospective Studies; D017150:Public Sector; D012052:Reimbursement, Incentive / Q000191:economics