Development funding: Development of social insurance

Disability allowances can be granted to persons with chronic illnesses or disabilities in order to facilitate and support their daily lives, rehabilitation and care  as well as their ability to work and study.  

Disability benefits comprise three types of disability allowances: disability allowance for persons under 16 years of age, disability allowance for persons aged 16 years or over and care allowance for pensioners. Each disability allowance is paid out at three different rates: basic rate, middle rate and highest rate. This three-tier benefit structure can pose a challenge to both customers and partner organisations. It may make it more difficult for customers to estimate how much allowance they might be able to get. The majority of disability allowances are paid at the basic rate, which is relatively low. Some allowances are granted for a fixed period, which means that the customer may have to apply for the allowance again. Customers may also seek to raise the rate of their allowance by submitting a new application or an application for a review of their allowance. This means that disability allowances add considerably to the workload of healthcare professionals because medical statements are needed for these applications. In addition, specialists at Kela need to devote considerable working time to deciding the rate at which a disability allowance should be paid to each customer, and customers then commonly appeal against these decisions. 

Kela seeks to commission a study on how the allowances are used by customers and whether this form of financial support makes a difference for the recipients.

The aim of the study is to generate data that address questions such as the following:

1. The use of disability benefits (from the perspective of customers, healthcare providers and social services)

   • How do the recipients of disability benefits use the benefits paid to them?
   • Do they use the benefits to e.g. pay for services that facilitate their care and rehabilitation or for activities that support their rehabilitation and improve their capacity to function independently, or do they have to spend the money they are paid in benefits on daily essentials?
   • Do customers use the benefits in a way that they themselves perceive as useful?
   • In the case of, for example, disability benefits paid at the basic rate, is the practical importance of the benefit for the customer significant enough to meet the objectives and purpose of the Act on Disability Benefits?
   • How important are disability benefits for the customer in the context of any other benefits paid by Kela and the services offered by the wellbeing services counties for persons with disabilities?
2. How could disability benefits be improved in light of the observations made during the study?

The maximum amount of funding available is EUR 100,000.

In the field of healthcare, clinical decision support systems help healthcare professionals manage a wide range of data by providing up-to-date and evidence-based information to support clinical work. These systems have been found to reduce errors, speed up treatment processes and improve patient safety. The use of automation and artificial intelligence tools in the compilation of digital statements (such as BC statements) offers new potential solutions for harvesting information and producing statement drafts.

Kela seeks to commission a study aimed at producing data to support the development of patient data systems.

The aim of the study is to generate data that address questions such as the following:

1. What clinical decision support systems are currently in use among healthcare professionals in Finland and internationally?
2. How could artificial intelligence tools and clinical decision support systems

   • help the doctor and the patient recognise which benefit(s) the patient needs and to compile essential information
   • alert the user about any missing data or documents (e.g. laboratory results, rehabilitation plan)
   • suggest treatments and rehabilitation options that are in line with Duodecim’s Current Care Guidelines
   • produce standardised sections of text that insurance providers can automatically use in pre-processing?
3. How could clinical decision support systems and automation assist in the process of applying for health-related benefits and in the preparation of BC statements?
4. Which data can be harvested automatically and how can the inclusion of all necessary data be ensured?

The maximum amount of funding available is EUR 100,000.

The reimbursement rate reform that entered into force on 1 May 2025 shifted the focus of the reimbursements payable for the costs of private oral healthcare services to preventive measures and the treatment of periodontal diseases. Even after the reform, there are over 300 reimbursable treatments and measures (codes), and providing guidance for and monitoring the use of these codes requires resources.

Kela seeks to commission a study to assess potential options for how the reimbursements for the costs of private oral healthcare services could be developed. The study must include an evaluation of procedure-specific and appointment-based reimbursement systems for private oral healthcare costs. The data produced by the study may be used later in the allocation and development of reimbursements for the costs of private oral healthcare services.

The aim of the study is to generate data that address questions such as the following: 

1. How could the reimbursements for the costs of private oral healthcare services be developed so that they would have an impact on morbidity and willingness to seek treatment?
2. What are the benefits and disadvantages of appointment-based and procedure-specific reimbursements?  
3. Could adopting an appointment-based reimbursement system have an impact on the oral health of the population? 
4. How could reimbursements for the costs of private healthcare services be further developed in the field of preventive oral healthcare?

The maximum amount of funding available is EUR 100,000.

Occupational healthcare plays a crucial role in supporting capacity for work, and the related operating models and the range of services offered have undergone significant changes in the past few years. These changes involve aspects such as preventive measures and practices for providing early support as well as cost management. 

Kela seeks to commission a study on the way these development trends affect capacity for work and, specifically, medical conditions that have a significant impact on a person’s ability to work. In addition, the study must cover the financial impacts of the changes and the potential for adopting different service models to reduce the costs caused by incapacity for work.

The aim of the study is to generate data that address questions such as the following:

1. How have the operating models of occupational healthcare and the range of services offered changed in recent years?
2. How have these changes affected costs?
3. How do the service models and the range of services affect the medical conditions that are significant vis-à-vis the capacity to work and the costs arising from inability to work?
4. What new kinds of services could occupational healthcare providers introduce to address current challenges to the capacity to work, such as sedentary lifestyles, obesity and mental health disorders?

The maximum amount of funding available is EUR 100,000.

Projects that received funding:

• Kuntoutussäätiö: Selvitys vammaisetuuksista
• NHG Finland: Päätöksentuen automaatio sähköisissä lausunnoissa
• Työterveyslaitos: Työterveystoiminnan muutos ja työkyky