For the past six months, Luxembourg’s first outpatient centre equipped with MRI, CT scan, and X-ray technology at Cloche d’Or has been ready to operate. However, despite long waiting times for appointments elsewhere, the facility, run by the Robert Schuman hospitals, has not yet been able to receive patients due to a lack of agreement on funding. After two years of negotiations between the National Health Fund (CNS) and the Hospital Federation (FHL), a deal was finally reached on Thursday.
The CNS and the FHL have now agreed on a model for financing medical activities delivered outside the traditional hospital framework.
Since 2023, services such as dialysis and chemotherapy have also been permitted outside hospital premises, alongside medical imaging. This broader scope of outpatient care added complexity to the discussions, as both institutions aimed to create a unified approach that could be applied to similar projects in the future. Christian Oberlé, President of the CNS, explained that the goal was to develop a consistent system with shared rules and logic, allowing all upcoming requests to be handled more efficiently under the same framework.
The process of designing the funding model proved particularly challenging, given its implications for the wider healthcare and hospital financing system. José Balazantegui, Senior Advisor to the CNS management, noted that for the past 25 to 30 years, hospitals in Luxembourg have been operating under a budget-based funding structure. Under this model, the healthcare institutions themselves receive funding, rather than specific services. The outpatient setting at Cloche d’Or, by contrast, requires a performance-based system that reimburses individual services – something Balazantegui described as a paradigm shift.
Thanks to its modern equipment and location outside of a hospital, the new outpatient site is expected to improve flexibility and reduce waiting times for patients. Its opening had been delayed by disagreements over a flat-rate reimbursement model, but this has now been resolved.
Because the site is considered a ‘supplementary location’ not directly attached to a hospital, it is subject to different legal and financial conditions. Dr Marc Berna, Director General of the Robert Schuman hospitals, emphasised that this new arrangement will allow a large portion of their outpatient activities to be reimbursed through a more adaptable and responsive model. He noted that this represents an opportunity for greater flexibility and agility in how care is delivered, particularly in reducing delays for patients.
Before operations can begin, however, the CNS and the FHL still need to determine the exact amounts the health fund will reimburse for services provided by the outpatient unit.
The discussions with the CNS have now paved the way for the country’s first outpatient hospital antenna. According to Oberlé, the facility is expected to open between September and December.
Although the negotiations focused solely on structural financing, Oberlé confirmed that patients will not see any change in service fees, whether treated in a hospital or at the outpatient site. The funding model has also been designed to support future initiatives, such as a planned oncology project by the CHL in Grevenmacher.
