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Reimbursement
Overview
Israel’s Reimbursement System is called “The Healthcare Basket.” It includes all the services, medications, supplies and medical equipment that the insured
is entitled to receive according to the National Health Insurance Law. It was originally determined based on the health services that were provided by the
Ministry of Health and the Clalit Health Fund as of January 1, 1994 and has been yearly updated by the Ministry of Health, based on recommendations by
a public committee.
The following fields of service are included in the healthcare basket:
• Diagnosis, consultation, and medical treatment
• Medications according to a list, some of which are provided only for a particular indication
• Hospitalization in a general hospital
• Rehabilitation, including hospitalization
• Accessories and medical supplies
There are several health services that, as of now, that re not included with the HMOs and remain the responsibility of the state:
• Well-baby clinics and inoculations
• Certain general rehabilitation devices, walking and other mobility devices, for which the Ministry of Health participates in the cost
• Health services for schoolchildren
• Nursing home stay
Reimbursement Historical Analysis
Oncology (solid tumors) HTs tend to have the greatest budgetary allocation per year, followed by Haemato-Oncology, Gastroenterology, Diabetes,
Cardiology, Neurology and Rare Dis.
A 20-year retrospective analysis of budget allocations shows:
As for Rare Dis./Orphan Drugs – there is no special budget and these HTs are competing with all other HTs. However, there is a clear tendency of
allocating larger parts of the budget to these therapeutic areas along last years:
Medical devices are kind of an “orphan area” with the reimbursement system, with a total of ~5% allocation of total budget (average over 20y):
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