Pilot study on freedom of choice in healthcare for persons aged 65 or over
The pilot study on freedom of choice in healthcare for persons aged 65 or over is a two-year pilot during which elderly customers can see a private general practitioner at the price of the local user fee charged by public healthcare providers. Kela is responsible for the implementation of the pilot study and for paying reimbursements and organising follow-up measures. The pilot study begins on 1 September 2025 and ends at the end of 2027.
The pilot study will improve access to treatment
The aim of the pilot study is to improve the availability of primary healthcare services, speed up access to treatment and provide more freedom of choice for customers. At the same time, the pilot study will produce new data that will help Kela develop its reimbursement system.
During the pilot study, the customer will pay up to the price of the local user fee charged by public healthcare providers for each appointment with a private general practitioner. Kela pays the remainder of the appointment fee directly to the service provider. The reimbursements provided by Kela during the pilot study also cover some of the most common examinations, tests and treatments, such as certain laboratory tests and imaging services.
Maximum prices will be set for the services included in the pilot study. This marks the first time ever that this measure has been tested in Finland for the reimbursements Kela pays for the costs of private healthcare services. The number of appointments is also limited to curb costs.
The pilot study is aimed at persons aged 65 or over because the need for healthcare services usually increases with age. This age group primarily uses public healthcare services and is not covered by occupational healthcare.
Research is an important facet of the pilot study
The pilot study on freedom of choice in healthcare for persons aged 65 and over introduces new regulatory elements, such as a maximum price that is set for eligible services.
A study will be conducted in connection with the pilot study to assess how successful it is and to determine whether similar practices should be integrated more permanently into the Finnish healthcare system. The study allows for the assessment of, for example, how quickly customers get access to treatment and the continuity of their care and their customer experience. In addition, the study can be used to assess the pilot study’s impact on the service load in wellbeing services counties and on the total costs of the healthcare system.
The pilot study will make use of the existing system of contract-based direct reimbursements. Kela hopes to see new service providers join the pilot study.
In its first year, i.e. 2025, the pilot study is expected to increase Kela’s reimbursement expenditure by approximately EUR 28.8 million, of which the state will cover approximately EUR 14.8 million. In the next two years of the study, i.e. 2026 and 2027, Kela’s reimbursement expenditure is expected to grow annually by approximately EUR 86.5 million. The state will cover approximately EUR 44.5 million of this sum per year. As such, the state is estimated to contribute a total of EUR 103.8 million to the pilot study in 2025–2027.