Optimalisatie van de werkingsprocessen van het Bijzonder ... - KCE

KCE Reports 133 Special Solidarity Fund 35
As can be seen in figure 2, in a small number of cases (0.7%), the actual reimbursement
is larger than the reimbursement specified in the application. This can be explained by
the fact that in these applications, the cost of a treatment is known only as an estimate
which is smaller than the final cost of treatment.
Figure 2: Medical costs in the SSF sample as specified in the application
versus as granted in function of treatment type (the dotted line corresponds
to full reimbursement).
Accepted applications tend to have a more substantial amount of reimbursement
specified in the application compared to declined applications, but declined applications
are not by default less expensive than accepted applications (see figure 3). Of the 10%
most expensive accepted applications, 1% is over €168.938, compared to €21.321 for
declined applications.