The "zorgkassen": a unique access point to social health insurance in Flanders

Abstract

In Flanders all citizens with a care need can apply for a health care budget to assist them in the extra expenses they face due to their precarious health and social circumstances. The “zorgkassen” are the single point of contact for the Flemish social protection. This means they act as the single access point for all questions concerning both professionals and citizens. These questions concern not only billing but also care requests about the Flemish social protection. The main purpose of this system is making care in Flanders financially accessible. The “zorgkassen” also collect the solidarity contribution every Flemish citizen contributes obligatory to the system. With these contributions and government funding, the “zorgkassen” can support defined groups through care budgets. 
 During the presentation we will show how this system of a unique access point and the sectors involved contribute towards integrated care. Through a client’s testimonial, we will show why the care budget makes a difference and also allows citizens to live longer at home.
 THE SINGLE POINT OF CONTACT
 This single point of contact put into pratice, the ""zorgkassen"" are responsible for: applications, disbursements, information about an individual case and the rights in the different parts of Flemish social protection. It makes procedures to open social rights within the system as clear and simple as possible for the citizens as well as the sector and the government. Even though ”zorgkassen” are focusing on digitalisation, they remain physically accessible to citizens at the same time. 
 Some examples of how the ”zorgkassen” contribute towards integrated care:
 
 The use of Interrai instruments (‘BelRai’)’ to identify the care needs of vulnerable people in a standardized way through one set of assessment tools: 
 
 The data are registered electronically which facilitates the exchange of information between different care actors, such as between facilities or institutions and individual care actors. Research is pending to investigate the implementation of BelRai as a case mix financing tool.
 Example: with a total score of at least 13 points on the BelRai Screener, you qualify for a care budget.
 
 
 Equal treatment for all citizens by automatically granting social rights: 
 
 By digitalising the various parts of the Flemish social protection, the “zorgkassen” can maximize their commitment to automatically granting social rights. The single point of contact has all the information on an individual case, allowing applications to be handled more efficiently and transparently. 
 Example: Residents staying in a residential care center in Flanders are automatically entitled to a care budget. 
 
 Another example for which the “zorgkassen” are the single point of contact: funding the multidisciplinary client meetings 
 
 A multidisciplinary client meeting is requested when the care becomes too complex and additional coordination between the person, the informal care and the care team is needed. The multidisciplinary client meeting is a method that helps facilitate integrated care in practice and helps build the bridge between care and welfare.