The Italian Council of Ministers has just approved the country’s new benefits package, which is expected to be available by the end of 2016 (State-Regions Conference, 2016).
The benefits package in Italy, known as the “basic levels of care” (Livelli Essenziali di Assistenza (LEA)) represents the national instrument aimed at achieving universal health coverage by guaranteeing entitlement to health care services. The services and procedures are considered “basic levels” because they cannot be denied or withheld from citizens. The LEAs were first published in 2001 but a general review has been due since their publication. After years of work, the new benefits package has been published, based on current epidemiological and demographic needs.
Unlike the previous legislation that defined the benefits package, which was limited to a general description of the sublevels of assistance, the new LEA Decree now becomes the primary source for defining in detail health care activities and services that are guaranteed to the population through public resources.
Important aspects of the new benefits package include:
- Additional services for ambulatory specialist services. For a small number of these services “deliverability conditions” or indications of “prescriptive appropriateness” have been identified
- New measures for high level innovation (such as prosthesis, etc.) have been introduced
- Obsolete services have been excluded
- The list of chronic and rare diseases for which patients are exempted from cost-sharing (co-payments) has been updated. New diseases have been added and the list of specific services to be delivered has been revised
- New vaccinations and neonatal screenings have been added
- Special attention has been given to specifying the most appropriate setting for services to be delivered. For example, 24 services now need to be delivered within ambulatory settings rather than as day surgery and 43 ‘potentially inappropriate’ admissions for ordinary hospitalisation have been identified. This is in keeping with specific provisions of Italy’s economic “Stability Laws” over recent years which in the health sector aim to enhance effectiveness of services as well as clinical appropriateness
- A National Commission has been set up for the continuous monitoring of the contents and outcomes of the benefits package