SFAO Audit: Healthcare costs at federal asylum centres
In 2023, healthcare expenditure amounted to CHF 65.5 million, or around 14% of the centres' total costs (CHF 461 million). The audit shows that the SEM remains too dependent on its health insurer and lacks reliable tools for managing costs. The SFAO recommends that the SEM improve the quality of its data to better defend its interests vis-à-vis insurance providers.
An insurance model chosen in haste
Since 2019, the SEM has entrusted health insurance for asylum-seekers to CSS. The contract was awarded following an unsuccessful tender, without a proper financial assessment of other options. In 2021, CSS raised the excess from CHF 300 to CHF 1,500, which increased the burden on the Confederation. According to the SFAO's assessment, a better tailored excess would have permitted savings of around CHF 1.5 million in 2023. The SEM and CSS do not have precise figures on their administrative and management costs.
Effective but dispersed local practices
FACs have developed several initiatives to limit costs: stricter medical triage, optimisation of medicine stocks and proactive vaccination. However, these good practices remain isolated. The SEM does not record them or implement them nationally.
Piecemeal and patchy cost management
The SEM does not have a consolidated database or a national dashboard. As a result, it cannot compare costs between centres or comprehensively manage its expenditure. The SFAO found it very difficult to obtain reliable data. Moreover, some information provided by the insurer was incorrect, and this was not picked up by the SEM. The SFAO requests that a unified system be put in place for collecting and validating data.
Full Report (German) : https://www.efk.admin.ch/prufung/gesundheitskosten-in-den-bundesasylzentren/