Andorran CASS Physiotherapy Patients Face Up to 4-Month Waits Amid Fee Stalls

**Andorran CASS physiotherapy patients face up to four-month waits amid fee negotiations and service expansions**

Patients covered by the CASS continue to encounter waits of two to three months for physiotherapy sessions, with some extending to four months due to high demand and scheduling issues. Theo Rogué, head of the Col·legi Oficial de Fisioterapeutes d’Andorra (COFA), linked the delays to an ageing population, broader treatment needs across age groups and chronic illnesses, and persistent administrative burdens despite digital progress with CASS.

The roster of CASS-affiliated physiotherapists stands at 137, down slightly from prior years among more than 200 COFA members, adding pressure on active providers. Rogué warned against holding professionals responsible for healthcare cost increases, which have actually declined by 2% in part due to fewer contracts. He stressed that physiotherapy helps prevent higher expenses from extended sick leave or operations, urging efficiency gains and quality upgrades before any fee adjustments to retain providers. Talks on rates, frozen amid inflation, remain stalled without proposed numbers.

Health Minister Helena Mas, during Thursday's launch of the updated Andorra Salut app, outlined close coordination with COFA to reshape services. She ruled out uniform fee rises as unhelpful, calling for tailored reviews of procedures, treatments and access given the sector's nuances. "It's a difficult area with many particularities," Mas noted, pointing to variations like shoulder treatments for young versus elderly patients, or manual versus device-based methods.

Mas confirmed some providers have exited contracts but described the shift as limited, with new approvals balancing losses and list audits removing inactive names. Plans include an initial inflation adjustment, followed by protocol evaluations and rate changes, though no deadlines were set. She described the work as intricate, favouring deliberate steps over quick measures, including refined referral systems and greater clinician independence.

In parallel, the Health Ministry is advancing dietitian and nutritionist services into the CASS portfolio after nearly four years since regulatory approval. The profession's college, led by Amaia Martioda, unanimously endorsed entry in a recent assembly. Final details cover tariffs, covered conditions and CASS agreements, targeting rollout this year following a one-year pilot.

The deal would reimburse two 30-minute visits per referral from a primary doctor, initially for issues like overweight, diabetes and eating disorders, with potential expansions. Specific rates have been discussed but not disclosed pending closure. Officials aimed for an early-year start but now expect completion within 2024, alongside broader tariff updates for groups including doctors and physiotherapists.

The app upgrade, unveiled by Mas, SAAS director Meritxell Cosan and technician Santiago Sánchez, introduces QR codes enabling foreign physicians to view Andorran diagnostic results via patient-shared links. It clarifies pending or scheduled referrals to avoid expired ones prompting repeat visits, adds a FAQ section for common SAAS queries, and refines navigation. With over 50,000 downloads, 25,000 active users and around 5,000 monthly logins, many features stem from user and staff feedback. Mas called it a "qualitative leap" in digital health transformation, centring citizens, with future telemedicine and nationwide online bookings in development. Sánchez emphasised intuitive daily information access to cut unnecessary trips.