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82 Musculoskeletal & Neurological Rehabilitation KCE reports 57
Normal production capacity (activity)
Costs
• Capacity is limited. To calculate the normal production capacity the
following indicators are used:
• An agreed number of places (Pl.), linked to equivalents (eq). For
example: centre 1 has 15 places with equivalent 1 (3 hours treatment)
for inpatients, 5 places with equivalent 0,66 (2 hours treatment) for
inpatients (In) and 25 places with equivalent 0,66 (2 hours treatment)
for outpatients (Out).
• Equivalents stand for a defined number of “treatment” hours. These
equivalents are however not the same for centres 1-2 (3 hours) and
centres 3-4 (6 hours), which hampers comparability.
• Working days/year (days). E.g. centre 1 has 250 working days , centre
3 has 236 working days
• The hypothesis of 90% utilization
• The above mentioned indicators determine the normal total capacity
(formula equivalent x places x working days x utilization rate (Util)
= normal total capacity).
• If a centre exceeds normal capacity the reimbursements of
expenditures is limited to a reduced percentage. If the centre exceeds
a second threshold value (maximum capacity), the reimbursements of
expenditures is limited to the lowest reimbursement (“overcap”).
• It must be remarked that for centre 2, where the duration of an
equivalent therapy session is defined as 3 hours and a 0,66 eq. as 2
hours, the actual treatment time for the patient is 4 repsectively 2,5
hours, as part of the therapy is given in group sessions.
• Personnel and operating costs incurred by the centres in the treatment
activities are submitted to RIZIV/INAMI. These costs have to be
negotiated and accepted by RIZIV/INAMI. Yearly, working costs are
partly indexed, personnel costs are fully indexed.
Cost / full equivalent treatment
• To determine the cost for the “full equivalent” treatment, total costs
are divided by normal total capacity. Equivalents are used to determine
the cost of other levels of (limited) treatments.
SECOND TYPE OF 7.71 CONVENTIONS
The second type 7.71 convention does not have an explicit cost model (Centres 5, 6 &
7, limitative list of pathologies). The prices are set in negotiation with RIZIV/INAMI.
Additional information on this (implicit) cost model was not found.
Full equivalents are based on a full day (6 hour) treatment.