Focus: Lazio Region Health Care Centralized Procurement and Centralized Payment System

The Italian National Healthcare System (NHS) is based on two tiers: Central government, and 21 regional administrations.
In 2005 Central government imposed a debt limit to regional administrations.Procurement strategies occupy an important position among Lazio Region’s instruments to enforce savings measures.

The Italian Law n. 299/2006 allows regional administrations to establish central purchasing Lazio Region “Central Purchasing Division” (CDP) is part of the “Central Purchasing Regional Department”. Its operative instruments have been enforced by the Regional Decree U0042/2010.

According to it, all the 21 regional Local Health Authorities (LHA) have to obtain a formal authorization before purchasing goods.

CPD is composed of 2 pillars: Centralized Procurement and Centralized Payment. A strong cooperation is foreseen between CPD and LHAs in planning and conducting competitive tenders, in identifying product categories which can be centralized, in collecting procurement needs and in the compilation of data forms.

CPD authorizes tenders and monitors LHAs with respect to regional directives, providing technical assistance to LHAs on complex tenders and producing specific studies to identify/single out the best opportunities to further reduce LHAs’ expenditures.

The Centralized procurement and Centralized payment Division implement also the “Settlement Agreements” based on an Electronic Billing System managing the centralized payments to the suppliers of goods and services, the digitalization of the entire process and the monitoring of the purchasing cycle. The implementation of these agreements involves suppliers of goods and services, nursing homes temporarily licensed by the National Health Service, research Hospitals and Treatment Centers, Private Hospitals temporarily licensed by the National Health Service and financial Institutions and factoring firms.

During the period 2009-2012, CPD conducted 32 tenders for a value of about €900 mln per year. In 2011, centralized tenders totaled savings amounting to €52 mln. Up to February 2013 invoices sent to the LHA are more than 1 million accounting for about €14 bln. €6 bln are processed through the Electronic Billing System per year out of €10 bln of a total RHS expenditure.