The Implications of the National Health Insurance Law and the Law Regulating the Practice of Healthcare Professions for Physical Therapy Services in Israel

Abstract

Methods: A qualitative study was conducted in 2012, based on interviews with all the national managers of PT services in Israel (13 managers) and on information available on Internet websites pertaining to these institutions. The interviews dealt with the general effects of the NHIL and the Law Regulating the Practice of Healthcare Professions for physical therapy, equity and accessibility of services, regulations, and supervision. Additional responses of senior medical directors from the HMOs were added as an appendix. Results: All of the managers noted the important contribution of the laws mentioned herein to regulating services and establishing standards for the quality of treatment and the professional training of physical therapists. However, they are aware of areas in which there is a gap between the law and the actual service provided. These gaps manifest mostly in the lack of equity between the services provided by each of the HMOs, between the services provided in the center of the country and those provided in the outlying areas and between the services provided by the HMOs and by other organizations. Providers differed in quality of service and treatment quota policies. The Ministry of Health audits its own state-funded PT services, but not those provided through other ministries. Conclusions: Physical therapy services are available throughout Israel as part of basic state-funded healthcare services. The gaps between the actual PT services and the services dictated by the laws are similar to services provided by other health-care professions in Israel. Several suggestions have been offered to improve the auditing system, including: 1. Establishment of a mechanism to evaluate PT services objectively; 2. Creating a framework of cooperation among the HMOs to solve lack of equity rooted in geographical distance; 3. The HMOs should be obligated to provide services to patients affiliated with the ministries of education and welfare; 4. Establishment of a training program to prepare physical therapists to work with people with developmental and intellectual deficiencies; 5. A committee should be established to review the issue of quota of treatments; 6. Mandatory continuous professional development should be established as a condition for renewal of licenses to practice PT. This would also contribute to the standardization of professional levels.