Estonian health fund to tie funding more closely to treatment results

The Estonian Health Insurance Fund (EHIF) plans to strengthen primary care and link more funding to treatment outcomes to help improve access and free up doctors' time.
The EHIF board on Monday approved its 2026–2029 development plan built around three main goals.
First, family doctor teams should handle most health concerns and be easier to access — in person, by phone or online. More care is to be delivered in health centers bringing together multiple specialists, with greater focus at the primary level on mental health and lifestyle-related conditions.
Second, funding will be tied more closely to quality of care and outcomes, while supporting people in taking a more active role in their own health. Instead of mainly paying per visit or procedure, more funding will depend on whether patients' health improves.
The plan also calls for more cooperation between doctors, expanded e-consultations and greater weight on patient feedback, and officials will also review which services should remain close to home and which should be centralized.
Third, the plan prioritizes better access to and usability of health data, aiming to cut time spent on documentation and allow more time for doctors to focus on patient care, while supporting treatment decisions, research and oversight of spending.
Budget still a critical challenge
Minister of Social Affairs Karmen Joller (Reform), who chairs the fund's supervisory board, said reducing EHIF's deficit remains a key challenge.
"When I took office as social affairs minister a year ago, projections showed EHIF reserves would run out by 2028," she said, adding that the planned €167.6 million deficit for 2025 was slashed by €75 million without reducing access to care.
Joller said current forecasts show reserves lasting until 2030, giving the fund time for reforms. She also highlighted improving transparency in EHIF's governance.
EHIF management board chair Siiri Lahe said the new development plan focuses on strengthening primary care to help prevent, detect and manage illness earlier.
She stressed that Estonia's healthcare system must be simple and easy for people to understand, with the right care available at the right place and right time.
"The development plan also supports the goal of moving toward a balanced budget," she said. "This requires a critical assessment of how far services can be efficiently optimized and whether, when and how much additional funding is needed for healthcare."
EHIF said the plan draws on domestic and international data, noting that while Estonia offers world-class healthcare, sustainability remains a challenge due to budgetary constraints and an aging population.
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Editor: Karin Koppel, Aili Vahtla









