In 2021 the Estonian Health Insurance Fund (EHIF) started to pay for the additional staff for the primary care providers working under contracts of primary healthcare centers. With this change, a primary care provider can hire an additional nurse or other medical supporting staff (e.g., a mental health nurse or clinical psychologist) to the team in addition to the minimum of 3 family doctors and 3 family nurses. Previously, every family physician could also hire a second nurse. The maximum EHIF compensation covers the cost of 6 nurses and one additional nurse or other medical specialist per 3 family physicians. The aim of the change is to tailor the service provision according to the actual needs of the patient lists. The providers can choose which expertise is needed the most. Furthermore, it is also possible to get compensated based on the actual working hours, making the system even more flexible and not assuming full time employment. A monthly allowance is paid to providers who applied for the additional funding. It is estimated that the change will result in a budget increase of 1,9 million euros.
In total there are 40 primary healthcare centers contracted with EHIF, including 225 family doctors with patient lists.Primary healthcare centers cover almost 30% of total patients in the country.