What about overspending in 2024? The Ministry of Health and the National Health Fund present data and a financing plan for 2025.
Overperformance for 2024, rising wage costs and the condition of district hospitals dominated the meeting of the Health Committee on September 8, 2025. Announcements from the government and the National Health Fund indicate that the fund has increased the pool for services, is implementing AOTMiT tariff recommendations with preference for level I-II hospitals, and is settling overperformance, while additional non-contributory funds are flowing into the system.
Secretary of State in the Ministry of Health Wojciech Konieczny presented current data on the liabilities of district hospitals.
As of March 31, 2025, total liabilities (due + non-due) of district hospitals amounted to PLN 8.775 billion, including due liabilities of PLN 1.288 billion. From 2020 to the end of Q1 2025, total liabilities increased by PLN 3.301 billion (~60%), and due liabilities by PLN 738 million (more than doubling). In Q1 2025 alone, the increase was +PLN 470 million in total and +PLN 104 million in due liabilities.
The Minister also pointed out that in the entire SP ZOZ segment, total liabilities in the first quarter of 2025 reached PLN 25.4 billion, of which PLN 3.4 billion were due, and the ratio of these indicators to the National Health Fund's expenditure on hospital treatment decreased compared to the average for the years 2010–2024.
Details regarding the settlements were presented by Jakub Szulc, President of the National Health Fund (NFZ), who supplemented the Minister's statement. He stated that the financial plan was increased several times in 2024, allowing for the financing of overpayments for 2023, the implementation of AOTMiT recommendations, and the coverage of overpayments from 2024, including those settled in early 2025. Regarding the fourth quarter of 2024, the President of the National Health Fund confirmed:
Non-limit overpayments were paid in 100%: PLN 1.614 billion; drug programs in 100%: PLN 761 million; surpluses in the PSZ lump sum (27% mechanism) PLN 299 million; 'limit' overpayments (excluding drugs) paid on average approx. 80–81% of the reported value (depending on the range 50–100%)." These actions were possible largely thanks to amendments to the National Health Fund plan in 2025, which increased the pool for benefits on the part of the fund and the state budget.
Publicly available information indicates that the National Health Fund (NFZ) has raised its financial plan for 2025 and amended contracts to provide healthcare providers with funds starting from July settlements. These plan changes, including an increase in the budget subsidy and the addition of a reserve fund, allowed for an increase in spending on services by approximately PLN 8.75 billion and the implementation of the AOTMiT (AOTMiT) tariff recommendations. In July, the fund also announced the release of additional funds for hospitals as a result of the 2025 recommendations and a gradual increase in contract values in the second half of the year.
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The basis for the tariff and coefficient modifications in 2025 were AOTMiT recommendations, including Recommendation No. 72/2025 regarding changes in pricing and correction coefficients for selected service areas, with particular emphasis on level I and II hospitals. The National Health Fund publicly announced the implementation of this recommendation and the tariff adjustments in neurology, gynecology-obstetrics, and rehabilitation, as well as additional coefficients in oncology. This is intended to translate into more stable financing for counties and improved liquidity for departments with a high service burden.
In parallel, the legal framework introduced solutions enabling additional funding for lump-sum surpluses exceeding 27% of the lump-sum value in 2024. District hospitals were among the main beneficiaries of the mechanism, as confirmed by the discussion of the Ministry of Health's regulation on the General Terms and Conditions of Contracts. These funds were supplementary and were directed to facilities with the largest gap between the planned and actual implementation of the lump-sum payment.
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The payment of overpayments coincided with the statutory increase in minimum wages for medical workers effective July 15, 2025, which increased the base operating costs of hospitals. The National Health Fund (NFZ) indicated that a growing share of non-contributory financing would be necessary, as contribution dynamics and unfavorable demographics did not offset the tiered wage increases. Additional funding through subsidies and reserve funds became one of the tools to offset cost pressures in facilities, particularly in district hospitals.
The Deputy Minister of Health summarized the package of changes and the scale of funding in 2025, and the implemented Option 3 of the Recommendation, which includes, among other things, higher correction factors for level I-II hospitals, new/realized tariffs (neurology, gynecology-obstetrics, inpatient rehabilitation), increases in areas requiring urgent intervention, and coefficients for selected oncology packages. The financial impact is: +PLN 16.9 billion (12 months; approximately +11.17% of the value of NFZ contracts, excluding B drugs and chemotherapy). Of this amount, approximately PLN 600 million for level I-II hospitals.
According to declarations submitted to the Health Committee, the priorities for the coming months remain the timely settlement of overpayments for 2024, the stable implementation of AOTMiT tariff recommendations, and supplementing funding with non-contributory funds. The real test of the effectiveness of these measures will come with the second half of 2025, when the cost of wage increases and the impact of new valuations on hospital liquidity will be fully revealed.
Source: Ministry of Health, National Health Fund, Parliamentary Health Committee Updated: 08/09/2025 20:22
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