Health activates the circuit to refer patients to mutual insurance societies and speed up sick leave for traumatological injuries

PalmThe Ministry of Health has established the monitoring commission for the agreement signed with the National Social Security Institute (INSS) and collaborating mutual insurance companies to improve the management of temporary incapacity and healthcare in cases of traumatological injuries. In this first session, the care pathway has been defined, which will allow patients to be referred from the Health Service to the mutual insurance companies with the aim of speeding up diagnostic tests and therapeutic and rehabilitation treatments.

According to the Ministry, the agreement —signed last July with the INSS, the mutual insurance companies collaborating with Social Security, and the Association of Mutual Insurance Companies for Work Accidents and Occupational Diseases (AMAT)— is a pioneer at the state level and has the support of employers and social agents. The agreement aims to strengthen coordination between institutions, reduce bureaucratic procedures, and shorten waiting times for temporary incapacity processes.

The protocol foresees the referral of patients with shoulder, meniscus, knee, and dorsal and lumbar intervertebral disc injuries, a set of pathologies that represent nearly 7,000 cases annually. Mutuals will be able to carry out diagnostic tests and apply treatments, always with the prior authorization of an IBSalut doctor and with the informed consent of the patient, which may be revoked at any time.

The Ministry has emphasized that all rights regarding privacy, confidentiality, and data protection are guaranteed, as well as coordination with public system healthcare professionals. In any case, the primary care physician will continue to be responsible for processing sick leave and return to work, establishing the initial diagnosis, and carrying out clinical follow-up.

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In this new model, the figure of the temporary incapacity manager of IB-Salut also gains importance, who will assume the coordination of administrative procedures to relieve healthcare professionals of these tasks. Furthermore, the results of tests and treatments carried out in mutual insurance companies will be available to family doctors through a specific technological viewer. The ultimate goal is to facilitate that people of working age with sick leave due to traumatological pathologies can access diagnoses and treatments more quickly, with the aim of reducing the duration of processes and improving healthcare efficiency.

The meeting was attended by the Minister of Health, Manuela García; the provincial director of the INSS in the Balearic Islands, Jesús García; representatives of AMAT, the employers' association CAEB, mutual insurance companies such as Fremap and Asepeyo, and trade unions UGT and CCOO, among others.

CAEB has positively valued the launch of the commission and has described the initiative as a “relevant step forward” to effectively apply the agreement and reduce the duration of sick leave. The employers' association has also advocated for the incorporation of technological tools as a key element to avoid unnecessary extensions of temporary incapacity processes.

Finally, it has underlined the importance of the commission carrying out operational monitoring of the agreement's functioning through indicators on the duration of sick leave, the number of referrals to mutual insurance companies, and response times, with the aim of detecting and correcting possible bottlenecks in the system.