STUDI NUMERO 31 - MAY 2015 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS 2014 AND PRIOR YEARS CENTRO STUDI • Andrea Guglieri • Sara Carbone Assobiomedica Research Centre Assobiomedica Research Centre Research Centre dedicated to Ernesto Veronesi Research Centre Director: Paolo Gazzaniga INDICE INTRODUCTION3 1 LATE PAYMENTS AND REFERENCE LEGISLATION 4 1.1EVOLUTION BETWEEN 1990 AND 2012 4 1.2RECENT DEVELOPMENTS 6 1.2.1 “DEBT-REDUCING” ACTIONS 6 1.2.2E-INVOICING 9 1.2.3 THE “SPLIT PAYMENT” SYSTEM 9 2 PAYMENT TIMES IN ITALY 10 2.1PUBLIC HEALTH ORGANISATIONS 1O 2.1.2 LATE PAYMENTS AT REGIONAL LEVEL 12 2.2 AVERAGE PAYMENT TIME FOR PRIVATE HEALTH ORGANISATIONS 14 CONCLUSIONS17 ANNEX 1 - METHODS 19 ANNEX 2 - DSO TABLES AND CHARTS PER REGION (1990-2014) 22 ANNEX 3 - DSO TABLES PER PUBLIC ENTITY (DECEMBER 2014) 64 ANNEX 4 - DSO TABLES PER PRIVATE ENTITY (DECEMBER 2014) 72 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS INTRODUCTION In 1991, Assobiomedica set up a debt monitoring centre in order to monitor how long it took for public health facilities to pay for the supply of medical devices. Since then, data relating to sales and amounts receivable provided by a panel of statistically representative companies in the industry, were processed every month for each region. The result of data processing is the DSO (days sales outstanding) index, which is the number of days between the invoice date and the payment date, or the average time it takes for a supplier to collect cash from its customers. Since 2011, data have also been processed for individual public bodies (monthly), and, since 2013, for Italy’s main private hospitals (every six months). This publication presents data referring to the average time it takes for private and public health organisations to pay their suppliers, updated in December 2014, tracing how the issue of late payments has evolved over the years in relation to the reference standard. In this regard, it should be recognised that decisive actions have been taken in the last two years that have had a significant impact in terms of reducing the average payment time for public healthcare organisations. However, given the nature of these actions, the improvement we have observed – which has not coincided with a similar improvement in average payment time for private organisations, the situation of which has even worsened – is not likely to be a real, structural improvement. 3 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS 1. LATE PAYMENTS AND REFERENCE LEGISLATION 1.1 EVOLUTION BETWEEN 1990 AND 2012 In those years, Assobiomedica made every possible effort to bring the issue to the attention of the European Commission, which in 1998 submitted to the European Parliament and Council an initial proposal for a directive, which was finally approved in 2000 after a long and troubled procedural process. Member States were required to implement it by 8 August 2002; it was transposed in Italy by Legislative Decree no. 231 on October 9, 2002. Although Italy was one of the few countries where a previous rule already existed against late payments 1the implementation of this measure – which in theory was one important step for the Country – did not significantly improve the situation in practical terms. In 2002, the country’s minimum and maximum DSO were 302 and 336 days respectively; in the following years (when the Directive entered into force in Italy), DSO were never less than 300 days, but grew to a peak in 2006, when they reached 331 days (minimum) and 372 days (maximum). On a regional level, from 1990 to the 2000s, the gap increased between “virtuous” regions and the worst performing ones: in December 1990, DSO were the highest in Calabria (495), Campania (482), Puglia (467) and Lazio (424); the lowest were reported in Valle D’Aosta (80), Trentino (119) and Piedmont (154); in December 2006 (the “annus horribilis”), the highest DSO were reported in Molise (912), Campania (837), Puglia (527), Calabria (488), Emilia Romagna (441) and Lazio (416), against the lowest in Trentino (85), Friuli V.G. (96) and Valle D’Aosta (101). Locally, the financial difficulties of health authorities emerged clearly for the first time in the late '90s and the first half of the 2000s: first the Policlinico Umberto I° University Hospital in Rome2 , then the Ordine Mauriziano Hospital in Turin3 . These incidents were different from each other, but unfortunately, as was clear from the beginning, they were not going to remain isolated cases4. The healthcare debt of Italian regions - grown by 44% during four years from 2000 prompted the first securitisations of trade receivables due from public health facilities between 2003 and 2006, first in Lazio, then in Abruzzo, Piedmont, Campania and Sicily. The first securitisation initiative - promoted by Assobiomedica in collaboration with UBS Investment Bank –was completed in July 2004, when Atlantide Finance issued asset-backed securities (ABS) with maturities of five years, for a total value of € 518 million. The region’s average DSO went from 664 days in June to 324 days in August. This first operation aroused great interest among international financial institutions 1 Law no. 833/1978. 2 Law Decree no. 431/1999, converted into Law no. 453/1999. 3 Law Decree no. 277/2004, converted into Law no. 4/2005. 4 In 2011, even the San Raffaele Hospital – one of Lombardy's top private healthcare centres – declared insolvency. Similar cases emerged recently (2013) at the Miulli Hospital (a private hospital with special agreements with the Puglia Region), the IDI, the San Giovanni Calibità hospital in Rome and the Maugeri Foundation in Pavia, all of which were prominent entities in the private health sector, yet they went bankrupt or are waiting for an arrangement with creditors. 4 (securities were distributed in Italy, Germany, Benelux, the UK and France) and such depth and breadth of the capital market paved the way for more, similar transactions in other regions. In Lazio alone, loans for a total amount of 2.3 billion euro were securitised between 2004 and 2006. These transactions proved an efficient financial solution. Regions could redefine the short-term maturities of their debt to suppliers according to a mid-term amortisation schedule, which was more in line with cash flows than a multi-year budget estimate. As a result, this measure cushioned the impact of accumulated debts on cash needs, as regions could spread payments over the medium term and thus reduce their financial cost. These transaction allowed suppliers to sell without recourse any receivables arising from invoices issued to the hospitals of the regions in question until a certain date at a cost of less than 1% of the capital, therefore on competitive terms compared to more traditional solutions. With these transactions, companies’ receivables were placed on the international capital market by directly leveraging the creditworthiness of the regions concerned, without having to go through any financial intermediaries. Nonetheless, the limit of these initiatives was the inability to make this gradual normalisation of debt payment time last over the years. In fact, at the end of every action taken in this respect, the stock of debt and DSO of Italian regions continued to rise. In 2010, while the European Commission modified its previous directive on late payments, making changes with regard to days of payment and default interest, the Italian legislature introduced a rule5that denied to public hospital suppliers (Section 1, paragraph 89 of Law no. 191/2009 - 2010 Finance Bill) to undertake or pursue any foreclosure actions against local health authorities or hospitals and limiting the interest rates they could earn to that provided by section 1284 of the Italian civil code (1% per annum with effect from 1 January 2010), subject to any agreements for lower rates between the parties. The law concerned the amounts due from health authorities and hospitals in the regions that signed “Healthcare deficit spending cut plans” pursuant to section 1, paragraph 180 of law no. 311 of December 30, 2004 – that is, the worst payers (Calabria, Campania, Lazio, Molise and Sicily). The Constitutional Court vetoed this prohibition in 20136. The European Commission has recently requested Italy to provide official information on the non-implementation of the new European directive7 on late payments. To date the arguments put forward by Rome8 don’t seem to have convinced Europe, which is ready to launch an infringement procedure against Italy. In 2012, the new Bankruptcy Law9introduced an alternative to traditional bankruptcy procedures, that is the concept of arrangement with creditors, which allows for the continuation of the business (or the sale of the company as a going concern, or the sale of the company to a “newco”) provided that the arrangement includes an analytical indication of the costs and revenues expected from the continuation of the 5 Section. 1 par. 89 of Finance Act 191/2009 - 2010. 6 Judgment no. 186/2013. 7 Decree no.192/2012. 8 The Italian Government justified itself by arguing that the directive would give the opportunity to choose between paying on time or paying a default interest of 8%. 9 Law no. 134 of August 7, 2012. 5 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS business, the financial resources required and how to cover them, as well as an expert report certifying that the continuation of the business will help pay off creditors. All this must be done with the prior authorisation of the competent court. The critical aspect is that, under this legal arrangement, debtors are allowed to freeze outstanding debts for a long time, and pay very low percentages to unsecured creditors. This causes a serious problem, especially when you consider the possibility that creditors themselves may be involved in bankruptcy cases, as it is likely to happen to suppliers of medical devices now that even several private healthcare facilities are going bankrupt. Finally, there have been significant developments in recent years, including the so-called “debt-reducing” decrees (2013-2014), and two measures that would affect the ability of regions and individual institutions to meet their commitment to pay their suppliers, namely the requirement to issue electronic invoices and the so-called split payment system for paying VAT. 1.2 RECENT DEVELOPMENTS 1.2.1 “DEBT-REDUCING” DECREES Between 2013 and 2014, with the entry into force of three decrees10, the Government stepped in to help pay the debt accumulated by local administrations, with three main objectives: 1. partially settle the amounts due to suppliers for debts accumulated until 31/12/2013; 2. quantify the exact amount of public debt (including healthcare debts); 3. allow creditors to transfer their credit to financial intermediaries in simple and less expensive ways. Overall, more than € 56 billion were made available for the payment of debts incurred by the government until 31 December 2013. The Bank of Italy estimated that the total public debt towards suppliers amounted to about € 91 billion at the end of 2012. In addition, the resources paid to debtors as of January 30, 2015 amounted to approximately € 42.8 billion, while, from these resources, the estimated amount paid to creditors was about € 36.5 billion. This was certainly an important economic measure, but not enough to cover all the estimated amounts due; this is also because, for now, only a part of the resources allocated by the Government has been paid to indebted institutions, and, in turn, this amount has not been entirely paid to creditors. Of the € 56 billion provided by the Government, € 14.5 billion were used to pay healthcare debts, including debts for the purchase of medical devices. Of that amount, only € 12.3 billion were claimed by regions, as several of them waived their right to that option. The cash advance provided by the government is in fact a loan that regions will have to repay in full to the Ministry of Economy and Finance (MEF) in 30 years, with an annual interest rate of 3.3%, weighing heavily on the future budgets of regions that decided to use them. As a result, several regions preferred not to worsen 10 Government Debt Payment» - J.O. no.132 of June 7, 2013; «IMU» - O.J. no. 66 of August 31, 2013; «Urgent measures for competitiveness and social justice» - J.O. no. 95 of April 24, 2014. 6 their situation. Table 1: Disbursements and payments to suppliers as per decrees no. 35/2013, no. 102/2013 and no. 66/2014 I Tranche II Tranche III Tranche IV Tranche Disbursments Payment to suppliers at 30/01/2015 ABRUZZO 174.009.000 174.009.000 174.009.000 BASILICATA BOLZANO CALABRIA 89.750.000 89.750.000 88.000.000 CAMPANIA 531.970.000 425.576.000 993.000.000 EMILIA-ROMAGNA 447.980.000 358.384.000 140.000.000 946.364.000 946.364.000 Region FRIULI LAZIO 832.052.000 LIGURIA 81.833.000 65.466.400 40.000.000 187.299.400 187.299.400 LOMBARDY MARCHE MOLISE 44.285.000 44.285.000 44.285.000 PIEDMONT 803.724.000 642.979.200 509.653.800 PUGLIA 185.975.000 148.780.000 318.171.000 652.926.000 652.926.000 SICILY 606.097.000 TUSCANY 230.753.000 184.602.400 404.000.000 819.355.400 819.355.400 TRENTO UMBRIA 17.222.000 12.226.632 29.448.632 29.222.000 777.231.000 810.249.000 4.822.881.000 2.491.429.600 4.913.757.527 SARDINIA VALLE D’AOSTA VENETO TOTAL 665.641.600 1.686.457.095 1.950.546.000 1.720.546.000 669.624.000 3.853.774.695 3.782.774.695 1.956.357.000 1.956.357.000 1.587.480.000 1.587.480.000 669.624.000 12.291.595.127 11.988.618.495 Source: Italian Ministry of Economy and Finance - website update on 30/01/15 7 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS Before the adoption of the decrees, there were no accurate data to indicate the extent of the outstanding debt, let alone the healthcare debt. To clarify this point, with Decree law no. 35/2013, Letta’s Government provided for a special survey of all debts accumulated before 31/12/12, except for those related to liabilities in dispute: unknown debts; debts relating to interest for late payments. The survey required each body to enter and record their debt on a special platform prepared by the MEF. The deadline was set on September 14, 2013. Despite there being heavy fines in case of default, according to the latest available data, which were never updated, the data recorded on the MEF platform would cover only 13,500 administrations out of about 22,000 (for a total survey of only € 3 billion)11. Given the unsatisfactory results the next Government, led by Renzi, saw fit to pursue the same goal by using the same method, but this time requiring creditors to enter data; this way, they could certify their credit, via the MEF platform, and then transfer the amount certified to financial intermediaries at favourable conditions. According to the decree n.91/20112, creditors can submit their application for certification via the MEF Platform for receivables due from: • central and local administrations; • autonomous regions and provinces; • local authorities, excluding those under the administration of an external commissioner due to mafia infiltration; • National Health Service institutions, except where in regions subject to healthcare deficit repayment plans or with ongoing debt acknowledgement actions (Campania, Lazio, Abruzzo, Calabria and Molise). By the decree n.66/201413 the MEF – in addition to postpone the deadline to apply for the certification of credits backed by State guarantee to 31/10/2014 - set a maximum amount for the discount that banks and financial intermediaries may apply to the transfer of credits granted until December 31, 2013 to public administrations until December 31, 2013 and certified after the entry into force of that decree. The above-mentioned decree provides that: • in transfer transactions, buyers cannot request a discount greater than 1.90% of the total amount of certified receivables, including any charges; • where the total amount of the transfer exceeds fifty thousand euro, buyers cannot request a discount greater than 1.60% per annum, including any charges, on the amount exceeding that threshold. In the same decree, the MEF has also provided for the negotiation of a framework agreement with the Italian Banking Association (ABI) to encourage and facilitate transfer transactions, then signed on July 21, 2014. In this case, the shortcoming is that if the amounts due from regions under the administration of external commissioners cannot be certified, the actual weight of the historic 11 Source: Il Sole24Ore issue no. 328 page 8 of November 29, 2013. 12 Converted into Law No. 116/2014, section 22, par. 7-b. 13 Converted into Law No. 89/2014. 8 debt (almost entirely concentrated in these regions) will never be really quantified; secondly, this will almost completely prevent any real opportunities for transfers of credit. In addition, the framework agreement between ABI and MEF does not require banks to buy credits under the conditions established by decree no. 66/2014; the final decision as to whether or not to buy them remains the discretion of each bank that is a member of the Italian Banking Association (ABI). 1.2.2E-INVOICING With MEF Decree No. 55/201314, all suppliers and public authorities are required to issue e-invoices, using a special procedure and platform set up by the Inland Revenue (Agenzia delle Entrate – AE). The decree implies two basic points: 1. as of 31/03/2015, public entities cannot accept invoices unless transmitted electronically via a special Interchange System (Sistema di Interscambio – SDI); 2. from 31/03/2015, public entities cannot make any payment, even partial, until they receive electronic invoices. The procedure is far from simple from a technical point of view, but both suppliers and, especially, public entities need to have a proper IT system that ensures all technical functions required for this service. For this reason, the Italian legislature has given suppliers and public authorities 2 years to adapt their IT systems to the new invoicing system. 1.2.3 THE “SPLIT PAYMENT” SYSTEM With the Law n. 190/201415 , the legislature has established that the value added tax (VAT) on the supply of goods or the provision of services to public entities, should be paid to tax authorities by public bodies themselves, in the manner and within the deadlines set by a MEF decree. This system, known as "split payment", came into effect on January 1, for the invoices issued after January 1, 2015. The decree provides that suppliers should issue invoices with the heading “split payment”, and collect their amounts receivable net of VAT, which the public bodies will then pay to the government. The measure taken requires both public entities and suppliers to make considerable accounting adjustments, especially when such measures are imposed without providing for a proper period of adjustment as has happened in this case. Another potential critical aspect for suppliers is that the reversal of the VAT payment system may cause a substantial reduction in liquidity. Although these amounts are clearly due to tax authorities regardless of who pays them, the time lag between collection and payment allowed suppliers to recover the VAT paid on purchases, and thus have continuous cash resources to cope with late payments or difficulties in accessing credit. 14 «Regulation on the issue, transmission and receipt of electronic invoices to be applied by local governments» O.J. no. 118 of May 22, 2013. 15 «2015 Stability Law», section 1, par. 629, letter b - published on O.J. no. 300 of December 29, 2014 n.300. 9 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS 2. PAYMENT TIMES IN ITALY 2.1 PUBLIC HEALTH ORGANISATIONS Despite all the limitations mentioned above, the funds allocated between 2013 and 2014 by the government still had a considerable impact on the timing of payment. In the national medical device industry, the DSO recorded in December 2014 reached a record low in 25 years. Nevertheless, the 60-day term set by the EU Directive is still a distant goal. In the two years from 2012 to 2014, Italy’s average payment time and total outstanding amount decreased by 40% (-110 days and about -2.9 billion euro respectively). The problem, if we analyse it on the basis of regional data, continues to have two sides: the side of regions where healthcare services, despite a general improvement, continue to have a major deficit (Calabria, Molise, Campania, Piedmont, Sicily) and regions from which we could reasonably expect a better performance (Tuscany, Veneto, Emilia Romagna, Puglia). As a comparison to the latter, we should mention the case of Lombardy: within three years – from 2008 to 2010 – the region managed to considerably reduce its DSO (which had reached up to 373 days in previous years), now stabilised at 90-100 days, without even resorting to government loans. In this case, establishing a centralised treasury has certainly helped, although we are convinced that what really made the difference was the Region’s firm determination to normalise payments and therefore make the top management of healthcare organisations more responsible. Both Campania and Piedmont are now trying to follow the Lombard example. In 2014, these two regions established how and when to centralise their payments. The two new regional treasuries should be fully operational by the end of 2015. With regard to the eight regions that are currently subject to repayment plans (all of which are using debt-reducing funds), we report a net reduction in the timing of payment for Puglia, Campania, Lazio and Abruzzo, an insufficient reduction for Piedmont and Sicily, while it still takes too long to pay for Calabria and Molise. Chart 1: Payment time in Italy in the last 25 years Source: Assobiomedica Research Centre. 10 Table 2: The impact of “debt-reducing” actions December 2012 Region December 2014 Estimate debt for medical device DSO Estimate debt for medical device DSO Change in debt Change in DSO 4.336 81 3.472 73 -864 -8 PIEDMONT 437.579 289 315.586 217 -121.993 -72 LIGURIA 120.567 179 64.968 102 -55.598 -77 LOMBARDY 251.873 98 215.498 84 -36.375 -14 21.894 72 21.773 70 -121 -2 380.378 250 144.551 105 -235.826 -146 36.642 76 44.225 88 7.583 11 EMILIA ROMAGNA 419.587 262 170.641 115 -248.946 -147 TUSCANY 328.884 258 236.241 169 -92.643 -89 MARCHE 68.443 134 39.086 78 -29.357 -56 UMBRIA 43.183 135 37.433 115 -5.750 -20 ABRUZZO 108.084 189 77.242 136 -30.842 -53 MOLISE 104.769 875 71.616 641 -33.153 -234 LAZIO 566.563 331 265.230 157 -301.333 -174 CAMPANIA 826.049 685 380.921 279 -445.127 -406 BASILICATA 23.000 131 23.649 138 649 7 PUGLIA 356.466 299 207.315 176 -149.151 -123 CALABRIA 443.892 913 315.769 669 -128.123 -244 SICILY 252.479 248 246.937 229 -5.543 -20 SARDINIA 113.219 243 74.210 145 -39.009 -98 NATIONAL 4.907.887 276 2.956.365 166 -1.951.522 -110 VALLE D’AOSTA TRENTINO A.A. VENETO FRIULI V. G. *Debt x 1000 Source: Assobiomedica Research Centre. 11 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS Fig. 1 – Regions subject to repayment plans (December 2014) Source: Assobiomedica Research Centre. 2.1.2 LATE PAYMENTS AT REGIONAL LEVEL DSO data for each public body revealed that the average payment time changes significantly from a public health facility to another, although in some cases they are only a few miles apart. Table 3 shows the best and worst DSO recorded in each region. These differences raise two sets of issues: 1. Locally – between institutions of the same region -, a likely lack of attention to proper management of the passive invoicing cycle; 12 2. At regional level – between institutions of different regions -, an equally probable inefficiency in the allocation of funds among health care companies, which to some extent wouldn’t take account of real needs. What emerges from the data for each public body is proof of the difference between Northern and Southern Italy. Indeed, if we consider the best payers, these all come from central and northern regions. On the other hand, the worst payers are only in southern regions. Calabria, in particular, stands out in negatively from other regions for counting among the worst payers 6 out of 10 institutions, with 5 of them in only two provinces, Catanzaro and Cosenza (tables 5 and 6). Table 3 – The best and worst payers by region (December 2014) REGION The best payers PIEDMONT Asl. 2 Alba LIGURIA Az. Osp. San Martino Genova LOMBARDY DSO at 31.12.14 108 The worst payers DSO at 31.12.14 Az. Osp. Citta della Salute e della Scienza Torino 440 72 Ente Osp. Ospedali Galliera Genova 158 Az. Osp. G. Salvini Garbagnate Milano 70 Az. Osp. S. Carlo Borromeo Milano 135 VENETO Asl. 7 Pieve di Soligo 54 Asl 16 Padova 162 FRIULI V. G. Az. Osp. Univ. Osp. Riuniti Trieste 60 Centro Riferimento Oncologico Pordenone 162 EMILIA ROMAGNA Az. Osp. Univ. Pol. S. Orsola Malpighi Bologna 54 Asl. Modena 163 TUSCANY Asl. 1 Massa Carrara Asl. 5 Pisa 336 MARCHE Az. Osp. Univ. Umberto I Lancisi Salesi Ancona 62 Az Sanitaria Unica Regionale Ancona UMBRIA Az. Osp. Perugia 61 Az. Unità Sanitaria Locale Umbria 2 Terni 127 ABRUZZO Asl. 4 Teramo 83 Asl. 2 Lanciano - Vasto Chieti 144 LAZIO Fondazione PTV Policlinico Tor Vergata Roma 103 Asl. Roma E 264 CAMPANIA Az. Osp. S. Giuseppe Moscati Avellino 147 Asl. Napoli 1 Centro 622 PUGLIA Asl. Lecce 148 Asl. Foggia 270 CALABRIA Az. Osp. (B.M.M.) Reggio Calabria 131 Az. Osp. Mater Domini Catanzaro SICILY Azienta Sanitaria Provinciale Ragusa 149 Az. Osp. Ospedali Riuniti Pappardo Piemonte Messina 363 SARDINIA Asl 8 Cagliari 77 Az. Osp. G. Brotzu Cagliari 229 109 79 1.459 Source: Assobiomedica Research Centre. 13 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS Tab. 4 – Ranking of the 10 best payers in Italy (December 2014) REGION PUBLIC ENTITY VENETO Asl 7 Pieve di Soligo DSO 54 EMILIA ROMAGNA Az. Osp. Univ. Pol. S. Orsola Malpighi Bologna 54 TRENTINO A.A. Az. Prov. per i Servizi Sanitari Trento 58 VENETO Asl 2 Feltre Belluno 59 FRIULI V.G. Az. Osp. Univ. Osp. Riuniti Trieste 60 UMBRIA Az. Osp. di Perugia 61 FRIULI V.G. Asl 4 Medio Friuli Udine 61 FRIULI V.G. Asl 3 Alto Friuli Gemona 62 MARCHE Az. Osp. Univ. Umberto I Lancisi Salesi Ancona 62 MARCHE Az. Osp. Ospedali Riuniti Marche Nord Pesaro 69 Source: Assobiomedica Research Centre. Tab. 5 – Ranking of the 10 worst payers in Italy (December 2014) REGIONI PUBLIC ENTITY CALABRIA Az. Osp. Mater Domini Catanzaro DSO CALABRIA AZIENDA SANITARIA PROVINCIALE Cosenza 817 CALABRIA Azienda Sanitaria Provinciale Catanzaro 797 CALABRIA Az. Osp. Pugliese - Ciaccio Catanzaro 718 MOLISE Azienda Sanitaria Reg. Campobasso 653 CAMPANIA AZ. SAN. LOC. NAPOLI 1 CENTRO Napoli 622 CALABRIA Azienda Sanitaria Provinciale Crotone 620 CAMPANIA Az. Osp. Osp. Riun. S.G Dio-R. D'Aragona Salerno 603 CALABRIA Az. Osp. di Cosenza Cosenza 583 CALABRIA AZIENDA PROVINCIALE Reggio Calabria 444 1.459 Source: Assobiomedica Research Centre. 2.2 AVERAGE PAYMENT TIME FOR PRIVATE HEALTH ORGANISATIONS Although the Italian market is predominantly public, we must not forget that over 26% 16 of sales of medical devices comes from private demand (accredited private hospitals and Religious Bodies). If in the late '90s and the first half of 2000, we saw the first, isolated cases of ascertained insolvency among private entities (the Ordine Mauriziano Hospital in Turin and the San Raffaele Hospital in Milan), cases of financial default have mushroomed in the past two years, with the escalation of the crisis, mainly involving Religious Bodies. If an institution’s bankruptcy was a very high cost to bear for creditors, the situation has even worsened with the introduction of arrangements with creditors as a going 16Source: Assobiomedica Research Centre – PRI Report 2014 14 concern, which allow institutions to freeze their outstanding debt, pay very low percentages to unsecured creditors and pay off the balance after 5 years17. Table 6 – Ranking of the 25 worst payers among private services (December 2014) REGION PUBLIC ENTITY AREA DSO LAZIO OSPEDALE GENERALE DI ZONA "SAN GIOVANNI CALIBITA" RM 1591 PUGLIA CONGREGAZIONE REL. SUORE ANCELLE DIVINA PROVVIDENZA BA 1399 PUGLIA CBH CITTA DI BARI HOSPITAL SPA BA 1287 PUGLIA OSPEDALE GENERALE REGIONALE F. MIULLI BA 1035 LAZIO MEDICAL PRODUCTS SRL RM 727 LAZIO A.C.I.S.M.O.M. RM 721 LAZIO AURELIA 80 S.P.A. RM 718 LAZIO GIOMI S.P.A. RM 619 PUGLIA LABORATORIO DOTT.PASQUALE PIGNATELLI S.R.L. LE 592 LOMBARDY IRCCS S.GIOVANNI DI DIO - FBF MI 528 LAZIO European Hospital RM 486 LAZIO EUROSANITA' SPA RM 484 TUSCANY SAN GIUSEPPE HOSPITAL AR 476 SICILY Centro Clinico e Diagnostico CT 467 LOMBARDY IRCCS CASA DI CURA MULTIMEDICA S.P.A. MI 466 CAMPANIA CASA DI C. PRIVATA MALZONI/VILLA DEI PLATANI AV 456 MOLISE NEUROMED I.R.C.C.S. IS 451 VENETO OSPEDALE VILLA SALUS OSP. GEN. DI ZONA VE 388 CAMPANIA Clinica Mediterranea Na NA 379 LOMBARDY FONDAZIONE SALVATORE MAUGERI CLINICA DEL LAVORO E DELLA RIABILITAZIONE PV 362 MOLISE FONDAZIONE DI RICERCA E CURA GIOVANNI PAOLO II CB 358 LAZIO POLICLINCO PORTUENSE SPA RM 347 CAMPANIA OSP. SACRO CUORE DI GESU' FATEBENEFRATELLI, PROV. REL. DI SAN PIETRO DELL'ORDINE OSPEDALIERO SAN GIOVANNI DI DIO, OSPEDALE BUCCHERI LA FERLA. BN 344 CAMPANIA Villa Dei Fiori S.R.L. NA 343 Source: Assobiomedica Research Centre. Note: Idi (failed), San Giovanni Calibità, Congregazione Religiosa Suore Ancelle della Divina Provvidenza, Fondazione Maugeri, Miulli (before the arrangement). 17 One example is the Miulli Hospital, a private institution operating in agreement with the Puglia Region, subject to an arrangement with creditors as a going concern. The arrangement with creditors ordered by the Bankruptcy Court of Bari required that unsecured creditors should be paid to the extent of 35.9% of all credits frozen until April 14, 2013 by December 31, 2018. As of today, the bankruptcy court has not yet implemented this arrangement, due to the entity’s failure to quantify the exact amount to be paid to unsecured creditors. 15 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS As in the public sector, the private institutions with greater difficulties are mainly in regions where healthcare systems are in crisis. As shown in Table 6, 16 of the 25 worst payers are located in Lazio, Puglia, Molise and Campania, which are regions where private healthcare institutions have always had a strong presence. However, even financially sounder areas such as Lombardy are not immune from cases of instability – think of the aforementioned San Raffaele Hospital in Milan or Pavia’s Fondazione Maugeri, both known for being prominent, cutting-edge facilities. There is no common reason to explain the causes of such failures. They range from ordinary economic/management inefficiencies to illegal phenomena that have little to do with any economic crisis. 16 CONCLUSIONS Despite the extraordinary financing measures arranged in favour of suppliers of public entities, in 2014 the average time it takes for public health organisations to pay their suppliers is still one of the longest in Europe. Besides, they did not lead to the same results in terms of improving the quantification of public debt or the transfer of credit. Electronic invoicing, however, is a tool that will considerably simplify transactions for the benefit of both public entities and suppliers. In the future, the mandatory use of a single system for sending and receiving invoices (SDI) will allow for a very precise, real-time quantification of the amount of public expenditure for each healthcare organisation. Although the amount of debt is likely to be high, the core of the problem is the level of uncertainty about this figure especially in some regions, such as Calabria. This uncertainty should be unacceptable, but inevitably ends up affecting any possible measure or recovery plan. In some cases, there are still obvious differences in terms of payment performance in different regions and hospitals. The persistence of late payments by public health organisations is due not only to a mere question of illiquidity by local governments, but also to a number of other factors: • widespread management inefficiencies in public health facilities with respect to cash flows; • the administrative slowness of public administration; • the poor effectiveness of the rules introduced by the national legislature to combat late payments, also due to the slowness of justice or a combination of conflicting measures that reduce their effectiveness. To achieve a real impact – possibly once and for all – on this normalisation process and get institutions to pay on time we should: • requiring bonds; the Government and the most heavily indebted regions to issue new • developing a plan for the gradual and massive sale of shareholdings held by the Ministry of Economy and Finance, from which to draw liquidity and in turn buy regional bonds; • develop similar plans for a gradual, and again massive, disposal of public pro- perty owned by the various regions, the proceeds of which should be used, at least in part and for a predetermined minimum amount, to pay off debts to suppliers and the regional bonds referred to in the first point; • implement a reform of legal procedures for credit recovery. This latter point deserves some attention. As has often been pointed out, one of the reasons why the rules against late payments are often disregarded in Italy – including the European Directives - is ascribable to overly lengthy civil justice procedures which, fact, drive creditors to find out-of-court settlements – that is, to endure the contractual breaches of public entities. The structure of debt collection proceedings (with an order for payment) is basically sound, their management time is what really causes serious problems for creditors. Therefore, a reform should be undertaken to significantly reduce the time it takes to get an injunction, or a reform that: 17 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS • makes the injunction immediately enforceable (for receivables from public entities supported by contractual documents such as orders, invoices and delivery notes) with a formal notice by registered mail, where the debtor does not object within 15 days; • it repeals the rule that currently requires enforcement orders to be re-notified, and the relevant period of 120 days, before an enforcement action can be initiated18. 18 For further information, Study No.28 The average payment times for public and private health organisations. 2013 and prior years - April 2014. 18 ANNEX 1 – METHODS In terms of method used, DSO indices relating to the entire country and individual regions are recalculated every month (based on data concerning sales and accounts receivable provided by the companies in the panel) using the following formula: ∑ accounts receivable for each company ∑ 12-month-rolling sales for each company x 360 This paper refers indifferently to payment time for healthcare organisations and collection by supplier companies, although a correct measurement of the former should take into account the date of registration of invoices and the date of submission of payment orders to the treasurer; a period ranging between 10 to 15 days should be attributed to postal service and treasurers. Besides, the DSO indexes we have calculated include the debts of regions with ongoing bankruptcy proceedings for entities that have ceased to operate; in these cases, it wouldn’t be accurate to speak about payment time for active healthcare organisations, given that the accounts for bankruptcy proceedings should not be included in the budgets of these organisations as they relate to special transitional management systems. The data we used include all amounts invoiced by the suppliers in the panel, including those related to invoices being challenged by public entities. All amounts include VAT and are net of any default interest, they refer to supplies to public entities with VAT chargeable on receipt of the payment (therefore excluding cases of sales to dealers and private healthcare facilities), and don’t include cases of non-recourse assignment of credit (e.g. to factoring companies).The limitation of this formula is that if there are significant changes in sales in a given month compared to the same month a year earlier, the DSO index would change accordingly regardless of the actual changes in payment time (i.e the DSO would increase if the companies’ total sales collapsed, or decrease if their total sales soared). However, the level of error is judged to be sufficiently low, and in any case limited to a short period of investigation, that is the few months when this should happen. A more accurate alternative for the calculation of DSO (which can be used by each company, but not by the Association as the latter collects less detailed data) is the “count back” method, shown below with an example. 19 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS Assume that the total amount receivable for survey month “t” is € 11 million and sales amount to € 4.5 million in the same month. If you subtract 4.5 from 11, the result is 6.5 million; at this point, count 30 days. If you subtract the turnover of month “t-1” (which we assume to be 3 million) from the remaining outstanding amount of 6.5 million, you will obtain 3.5 million; then count another 30 days (which, added to the previous thirty days, equals 60). If you subtract the turnover of month “t-2” (which we assume to be 2 million) from the remaining outstanding amount of 6.5 million, you will obtain 3.5 million; then count another 30 days (which, added to the previous thirty days, equals 90). At this point, assume that the turnover for month “t-3” was € 6 million: since that turnover is higher than the remaining outstanding amount, instead of subtracting the first from the second, we need to calculate a "daily" turnover for the month “t-3” (i.e. € 6 million divided by thirty days = € 200,000 per day) and then calculate how many days of turnover would equal the remaining outstanding amount (€ 1.5 million divided by € 200,000 per day = 7.5 days). After doing this, simply add 7.5 days to the previous total of 90 days to obtain the updated DSO for month “t”. It should be considered that monitoring the average time it takes for healthcare organisations to pay their suppliers is only the first step towards a proper measurement of the problem, i.e. measuring the actual credit of supplier companies. In fact, the average payment time for each region should be weighed by taking into account the underlying debt, which in turn depends primarily on the level of expenditure (again regional) behind it; quite simply, it costs more to have a debt exposure of € 5 million for two hundred days than a debt of € 500,000 for four hundred days. Based on this simple consideration, at the end of the 1990s, Assobiomedica developed the so-called “DeP index”19, which unlike the DSO index was created to take into account both the absolute average payment time and the relative weight of the total accumulated debt. The disadvantage of this index – which limits its usefulness in terms of communication – is that it cannot be immediately interpreted in numbers (it is not expressed in number of days like the DSO index, it does not indicate percentages, or other data), referring to a conventional ranking system (table 7-8). The DeP index is calculated by adding the scores of debtors in two special rankings: the DSO ranking, consisting of 13 positions going from p1 (= payment time of approximately one month) to p13 (= payment time of more than one year), associated with a score from -1 to +5; the “OVERDEBT” ranking consisting of 11 positions going from d1 (= the overdebt 20 of the subject in question weighs no more than 1% of the total market) to d11 (= the overdebt weighs 19 Overdebt and payment performance. 20 “Overdebt” means the difference between the actual debt and the debt resulting from a DSO of 90 days. 20 more than 10% of the total market) associated with a score from 0 to +10. For illustration, consider the following example taken from the healthcare sector: if a region’s hospitals always paid their suppliers within 90 days, and therefore had no other debts except their invoices for the last three months, the region’s DeP index would be 0; on the other hand, if hospitals paid after more than one year and the total accumulated debt weighed more than 10% of the Italian market, their DeP index would be 15. In general, therefore, the higher the DEP index, the more financially burdensome the situation for suppliers in that region. Tables 7-8 – Scheme for the construction of the DeP index PAYMENT PERFORMANCE CLASSES PERIOD OF DEBT DSO POINTS DEBT STATUS CLASSES OVERDEBT AS % OF MARKET POINTS 1 1 MONTH < 45 -1 1 1% 0 2 2 MONTHS 46-75 -0,5 2 2% 1 3 3 MONTHS 76-105 0 3 3% 2 4 4 MONTHS 106-135 0,5 4 4% 3 5 5 MONTHS 136-165 1 5 5% 4 6 6 MONTHS 166-195 1,5 6 6% 5 7 7 MONTHS 196-225 2 7 7% 6 8 8 MONTHS 226-255 2,5 8 8% 7 9 9 MONTHS 256-285 3 9 9% 8 10 10 MONTHS 286-315 3,5 10 10% 9 11 11 MONTHS 316-345 4 11 > 10% 10 12 12 MONTHS 346-375 4,5 13 > 12 MONTHS > 375 5 21 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS ANNEX 2 DSO TABLES AND CHART PER REGION (1990-2014) ITALY Italy January February March April May June July August September October November December 22 DSO 2013 283 285 283 278 274 272 270 256 243 232 225 211 DSO 2014 215 211 209 207 201 204 201 190 181 180 172 166 Italy 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 DSO MIN. 285 264 271 322 301 313 259 241 258 277 282 267 302 DSO MAX 318 320 330 357 340 359 336 307 299 294 290 306 336 Italy 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 DSO MIN. 305 300 305 331 286 269 259 273 286 276 211 166 DSO MAX 346 330 337 372 351 315 292 297 307 317 285 215 January February March April May June July August September October November December January February March April May June July August September October November December January February March April May June July August September October November December 1990 1991 1992 1993 1994 1995 1996 1997 1998 285 295 296 301 306 307 318 307 305 299 295 288 293 306 315 320 313 305 308 292 294 291 286 264 271 277 276 283 290 299 307 307 317 317 330 319 332 346 346 345 342 347 357 342 336 333 331 322 331 340 339 337 330 329 338 328 325 324 317 301 313 321 324 341 339 346 359 350 341 334 328 317 327 329 330 325 326 330 336 311 297 285 274 259 273 279 288 290 292 296 307 290 275 271 261 241 258 271 279 279 278 288 299 291 290 291 289 281 1999 2000 2001 2002 2003 2004 2005 2006 2007 282 287 284 283 284 289 294 288 282 282 280 277 282 290 285 286 285 287 290 282 286 287 288 285 292 299 299 305 306 303 305 295 287 290 287 267 302 315 308 312 316 327 336 326 318 320 322 322 331 342 346 332 333 331 337 324 315 314 314 305 326 324 322 325 321 330 320 300 303 309 308 303 317 337 329 327 305 310 319 315 315 317 321 311 331 339 338 342 351 361 372 341 345 351 358 336 351 348 347 348 331 333 340 327 330 311 312 286 2008 2009 2010 2011 2012 2013 2014 298 303 311 315 311 313 292 290 288 281 287 269 280 288 289 292 287 273 276 269 269 268 268 259 273 279 284 287 287 288 297 290 288 283 282 278 286 289 296 301 294 298 307 305 306 304 305 307 317 315 316 307 303 301 301 291 284 280 281 276 283 285 283 278 274 272 270 256 243 232 225 211 215 211 209 207 201 204 201 190 181 180 172 166 Source: Assobiomedica Research Centre, Observatory on receivables 23 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS ABRUZZO Abruzzo January February March April May June July August September October November December 24 DSO 2013 195 189 184 190 195 186 184 171 158 152 139 137 DSO 2014 143 141 138 135 131 135 139 139 139 141 138 136 Abruzzo 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 DSO MIN. 295 252 267 314 340 243 183 154 169 162 189 182 246 DSO MAX 359 345 295 374 389 342 297 192 216 203 217 231 351 Abruzzo 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 DSO MIN. 364 420 493 275 290 209 177 182 199 187 137 131 DSO MAX 450 544 596 574 400 345 223 225 235 211 195 143 January February March April May June July August September October November December January February March April May June July August September October November December January February March April May June July August September October November December 1990 1991 1992 1993 1994 1995 1996 1997 1998 n.d. n.d. n.d. 351 359 353 357 335 322 309 301 295 324 340 329 330 345 327 336 308 294 282 271 252 267 273 283 282 289 283 281 280 291 288 293 295 314 337 351 355 347 359 374 360 353 339 336 328 354 375 365 355 357 366 389 374 377 378 360 340 339 342 330 327 301 289 312 302 277 267 269 243 280 297 292 291 269 252 249 227 201 183 187 189 191 192 192 181 179 182 188 172 158 160 160 154 169 175 180 173 188 205 216 207 198 194 194 186 1999 2000 2001 2002 2003 2004 2005 2006 2007 196 203 195 180 162 165 181 175 180 171 170 184 198 217 211 199 189 199 212 208 209 203 223 226 224 225 217 209 200 182 183 186 200 203 211 231 261 264 247 246 268 288 306 306 312 326 340 351 364 423 400 407 414 437 450 434 432 423 428 431 427 420 436 440 450 471 499 507 524 541 544 536 543 584 596 493 506 526 538 538 549 555 553 544 544 574 570 453 476 504 530 537 557 556 573 275 290 298 308 316 321 342 375 374 393 395 400 330 2008 2009 2010 2011 2012 2013 2014 345 338 332 292 287 286 281 280 282 252 248 209 205 212 217 215 200 219 223 219 211 223 220 177 182 199 202 204 207 216 225 210 211 213 210 204 225 235 234 224 212 209 220 211 209 207 204 199 211 207 198 195 188 188 187 191 190 190 191 189 195 189 184 190 195 186 184 171 158 152 139 137 143 141 138 135 131 135 139 139 139 141 138 136 Source: Assobiomedica Research Centre, Observatory on receivables 25 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS BASILICATA Basilicata January February March April May June July August September October November December 26 DSO 2013 144 138 138 139 138 144 149 148 147 137 137 143 DSO 2014 146 146 136 136 134 139 135 133 131 131 127 138 Basilicata 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 DSO MIN. 230 188 202 215 221 159 97 115 130 124 120 155 164 DSO MAX 281 286 268 253 273 273 163 158 177 167 159 186 220 Basilicata 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 DSO MIN. 120 148 171 208 165 143 143 123 130 131 137 127 DSO MAX 211 212 214 284 265 200 225 161 150 160 149 146 January February March April May June July August September October November December January February March April May June July August September October November December January February March April May June July August September October November December 1990 1991 1992 1993 1994 1995 1996 1997 1998 n.d. n.d. n.d. 281 256 264 234 223 244 241 240 230 188 274 278 286 274 274 280 239 256 260 257 244 268 267 248 221 237 237 230 202 215 220 231 225 239 249 228 230 228 236 231 215 221 243 253 254 265 273 248 233 221 234 268 276 268 269 235 222 239 285 260 273 265 183 192 173 167 170 181 159 145 163 148 151 146 146 162 140 126 117 109 97 115 132 147 145 142 139 158 144 153 126 122 117 130 150 153 166 164 171 175 177 157 164 150 131 1999 2000 2001 2002 2003 2004 2005 2006 2007 148 163 156 133 134 153 167 159 149 156 136 124 135 148 147 147 141 145 156 159 157 120 138 120 155 168 166 150 158 167 174 178 177 173 186 182 220 220 164 181 186 182 190 187 179 196 212 203 186 219 190 146 142 146 148 128 125 120 148 150 181 171 173 160 174 202 212 183 178 173 152 148 171 196 199 199 211 210 214 197 199 195 185 179 208 218 223 241 236 252 274 265 284 252 244 240 251 265 194 196 189 192 184 176 182 181 183 165 2008 2009 2010 2011 2012 2013 2014 177 175 171 200 188 178 177 168 155 147 143 153 173 184 197 205 204 225 212 187 193 170 167 143 161 138 139 139 145 147 159 145 124 123 127 127 147 150 140 135 133 130 138 134 138 148 143 146 160 159 158 155 144 149 155 146 135 133 132 131 144 138 138 139 138 144 149 148 147 137 137 143 146 146 136 136 134 139 135 133 131 131 127 138 Source: Assobiomedica Research Centre, Observatory on receivables 27 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS CALABRIA Calabria January February March April May June July August September October November December 28 DSO 2013 922 932 930 936 926 946 960 970 977 960 901 832 DSO 2014 833 840 836 848 845 843 841 797 751 731 692 669 Calabria 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 DSO MIN. 421 469 516 561 631 634 382 235 205 211 225 223 258 DSO MAX 514 521 566 686 686 691 638 384 274 259 258 256 320 Calabria 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 DSO MIN. 296 331 409 385 497 523 615 771 877 913 832 669 DSO MAX 342 389 485 506 556 604 784 858 979 1010 977 848 January February March April May June July August September October November December January February March April May June July August September October November December January February March April May June July August September October November December 1990 1991 1992 1993 1994 1995 1996 1997 1998 n.d. n.d. n.d. 430 421 432 512 503 459 466 514 495 490 473 480 509 496 469 505 489 505 521 517 512 532 545 543 520 519 516 522 535 540 557 566 562 561 578 595 601 607 620 654 641 631 626 623 628 631 636 634 651 663 658 653 659 667 678 686 670 653 646 646 675 653 659 682 678 691 661 651 634 637 638 594 562 543 521 521 488 450 438 426 382 384 368 336 311 293 291 297 281 279 277 266 235 233 244 239 241 247 255 269 274 261 260 244 205 1999 2000 2001 2002 2003 2004 2005 2006 2007 219 230 211 216 233 246 259 257 256 248 248 254 258 233 233 231 235 240 247 240 242 243 225 230 252 256 247 236 229 230 237 229 223 223 228 231 286 304 295 279 258 298 302 301 312 320 320 315 296 303 308 305 317 324 334 324 328 329 333 342 355 346 353 351 331 333 354 353 348 362 373 389 409 436 434 435 445 456 473 468 477 485 484 457 385 386 387 394 415 436 456 463 474 486 506 488 497 503 512 525 521 545 550 546 538 547 554 556 2008 2009 2010 2011 2012 2013 2014 523 524 526 532 529 548 549 539 549 584 604 602 615 634 652 652 661 680 693 704 723 736 763 784 809 792 778 777 771 788 800 800 813 828 838 858 877 880 878 912 922 931 941 940 940 976 979 974 993 988 999 998 1010 993 990 951 943 914 925 913 922 932 930 936 926 946 960 970 977 960 901 832 833 840 836 848 845 843 841 797 751 731 692 669 Source: Assobiomedica Research Centre, Observatory on receivables 29 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS CAMPANIA Campania January February March April May June July August September October November December 30 DSO 2013 682 682 677 654 644 585 570 555 545 507 484 456 DSO 2014 440 426 396 374 357 367 341 327 305 303 288 279 Campania 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 DSO MIN. 482 468 466 547 536 559 472 400 400 365 326 323 322 DSO MAX 533 524 542 595 591 679 645 506 447 445 367 354 399 Campania 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 DSO MIN. 400 432 547 616 489 534 606 648 731 685 456 279 DSO MAX 432 539 621 856 859 620 644 755 803 805 682 440 January February March April May June July August September October November December January February March April May June July August September October November December January February March April May June July August September October November December 1990 1991 1992 1993 1994 1995 1996 1997 1998 n.d. n.d. n.d. 533 518 503 523 503 518 508 494 482 494 491 511 492 468 475 524 517 492 495 499 472 466 484 484 485 499 507 519 527 538 542 542 542 558 595 595 589 574 587 575 564 564 547 547 550 569 572 536 568 567 576 591 580 586 590 582 567 559 578 583 616 626 657 679 667 664 653 634 623 628 633 645 626 614 604 594 533 513 495 490 472 497 485 506 475 475 457 473 460 421 417 410 400 427 440 464 450 457 457 467 449 432 419 400 421 1999 2000 2001 2002 2003 2004 2005 2006 2007 445 429 416 413 426 430 434 426 429 430 386 365 349 362 349 342 326 346 349 346 361 367 364 345 340 354 346 328 323 327 335 323 329 333 336 323 322 343 347 353 362 382 388 379 382 395 394 399 421 432 418 416 417 423 418 400 412 407 408 401 432 447 465 480 477 482 496 497 515 531 539 533 547 558 571 582 573 585 600 604 611 611 621 596 616 637 673 686 718 731 777 786 810 835 856 837 859 844 797 747 496 515 497 489 500 514 531 517 2008 2009 2010 2011 2012 2013 2014 534 551 566 575 602 620 601 599 604 596 609 609 618 615 616 608 611 639 623 606 608 628 644 641 648 664 662 674 690 694 717 714 744 755 740 745 756 731 769 765 744 771 778 779 786 802 803 795 805 801 803 804 801 782 770 748 732 719 709 685 682 682 677 654 644 585 570 555 545 507 484 456 440 426 396 374 357 367 341 327 305 303 288 279 Source: Assobiomedica Research Centre, Observatory on receivables 31 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS EMILIA ROMAGNA Regione January February March April May June July August September October November December 32 DSO 2013 271 272 270 262 255 253 244 213 200 175 164 138 DSO 2014 148 141 144 142 143 152 152 141 127 127 124 115 Regione 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 DSO MIN. 233 221 239 242 257 274 288 285 305 337 279 238 275 DSO MAX 330 348 347 318 307 347 367 430 373 365 366 313 311 Regione 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 DSO MIN. 296 325 363 385 367 260 249 263 273 262 138 115 DSO MAX 332 357 404 465 485 379 291 294 296 307 272 152 January February March April May June July August September October November December January February March April May June July August September October November December January February March April May June July August September October November December 1990 1991 1992 1993 1994 1995 1996 1997 1998 n.d. n.d. n.d. 310 318 330 321 324 309 255 274 233 277 318 348 341 273 241 244 231 231 231 228 221 239 251 255 266 273 275 285 290 300 321 347 306 309 318 314 278 282 279 291 266 267 275 263 242 257 276 285 282 270 272 296 300 306 307 289 266 280 289 304 323 332 337 347 332 318 305 293 274 288 293 303 319 336 356 367 354 339 336 321 311 326 338 357 374 398 412 430 385 362 376 351 285 305 318 328 332 339 349 360 353 360 373 371 325 1999 2000 2001 2002 2003 2004 2005 2006 2007 344 348 350 361 358 365 359 337 347 356 354 352 366 363 347 337 331 315 313 293 305 307 303 279 285 287 284 300 313 294 298 278 282 290 282 238 275 290 298 309 309 303 311 293 288 296 304 303 325 330 332 301 301 306 322 318 305 313 303 296 334 343 339 328 325 333 334 335 340 354 357 353 363 378 384 371 363 375 382 383 388 397 404 397 408 414 385 394 399 388 404 411 429 443 465 441 460 472 485 483 445 425 421 399 402 396 387 367 2008 2009 2010 2011 2012 2013 2014 374 371 379 370 318 309 301 297 286 283 294 260 282 286 287 286 291 290 276 260 249 252 257 252 270 271 275 273 275 286 294 285 281 279 282 263 273 282 289 290 285 289 296 295 290 287 293 287 307 303 301 295 289 289 283 275 267 265 269 262 271 272 270 262 255 253 244 213 200 175 164 138 148 141 144 142 143 152 152 141 127 127 124 115 Source: Assobiomedica Research Centre, Observatory on receivables 33 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS FRIULI VENEZIA GIULIA Friuli V.G. January February March April May June July August September October November December 34 DSO 2013 88 90 87 84 84 89 89 85 85 90 89 84 DSO 2014 90 85 80 80 77 82 80 81 73 74 77 88 Friuli V.G. 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 DSO MIN. 174 184 186 173 178 162 122 135 106 119 102 119 98 DSO MAX 210 245 227 204 227 244 177 194 195 154 132 148 156 Friuli V.G. 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 DSO MIN. 96 86 87 96 81 65 68 71 86 76 84 73 DSO MAX 120 122 129 126 115 94 90 93 102 104 90 90 January February March April May June July August September October November December January February March April May June July August September October November December January February March April May June July August September October November December 1990 1991 1992 1993 1994 1995 1996 1997 1998 n.d. n.d. n.d. 210 186 187 195 192 204 181 191 174 192 208 201 219 245 239 226 216 209 204 202 184 202 201 192 204 212 191 227 222 210 216 197 186 204 193 194 193 190 188 201 177 170 173 178 173 192 216 207 211 220 227 227 222 214 206 192 178 183 202 221 237 242 232 244 238 220 211 189 162 169 174 173 171 170 177 172 168 156 150 138 122 138 148 156 173 175 187 194 185 157 156 148 135 157 176 189 191 180 188 195 177 166 158 154 106 1999 2000 2001 2002 2003 2004 2005 2006 2007 125 128 134 126 120 143 154 139 132 130 121 119 120 131 122 132 127 128 129 116 121 118 112 102 119 121 129 134 140 143 144 138 129 145 140 138 123 122 124 135 143 145 156 128 123 112 112 98 107 110 112 112 115 120 118 110 98 102 107 96 106 110 118 122 117 118 115 111 101 97 92 86 87 126 123 125 125 122 129 120 114 107 103 94 112 120 123 126 120 110 124 107 103 97 101 96 110 113 109 115 110 114 106 96 97 91 89 81 2008 2009 2010 2011 2012 2013 2014 92 94 91 90 83 91 92 77 79 71 70 65 83 86 90 85 79 79 85 76 72 68 74 75 82 81 89 93 91 90 93 79 82 85 71 73 86 89 93 90 90 88 100 98 100 102 101 99 104 103 100 95 93 90 88 84 81 84 80 76 88 90 87 84 84 89 89 85 85 90 89 84 90 85 80 80 77 82 80 81 73 74 77 88 Source: Assobiomedica Research Centre, Observatory on receivables 35 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS LAZIO Lazio January February March April May June July August September October November December 36 DSO 2013 332 330 308 315 318 327 322 321 301 296 281 293 DSO 2014 280 255 257 260 255 251 235 192 181 181 168 157 Lazio 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 DSO MIN. 412 390 413 488 487 553 547 518 527 565 578 545 622 DSO MAX 459 471 487 546 549 636 679 564 578 582 611 611 684 Lazio 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 DSO MIN. 557 355 342 325 434 378 315 377 367 315 281 157 DSO MAX 694 671 517 618 614 530 484 425 403 411 332 280 January February March April May June July August September October November December January February March April May June July August September October November December January February March April May June July August September October November December 1990 1991 1992 1993 1994 1995 1996 1997 1998 n.d. n.d. n.d. 412 431 441 453 453 459 435 429 424 390 443 471 449 432 422 440 406 399 402 405 402 413 426 431 431 439 448 458 457 472 476 487 480 488 513 514 514 530 539 546 528 507 504 497 492 487 502 516 515 506 507 514 502 517 535 549 548 553 572 582 598 601 619 636 629 625 617 615 604 618 633 649 627 637 645 626 679 599 602 585 547 555 543 554 533 531 545 564 543 540 547 533 518 527 538 540 544 544 547 573 568 578 577 575 552 1999 2000 2001 2002 2003 2004 2005 2006 2007 565 572 569 569 568 568 570 576 575 575 578 582 578 590 583 592 587 587 585 582 581 593 611 613 581 600 611 609 613 598 599 592 591 600 601 545 622 641 630 630 629 650 657 657 665 677 672 684 694 702 705 617 611 585 568 557 586 607 599 605 626 636 655 671 633 661 491 355 370 387 401 414 442 463 499 517 342 354 370 386 403 420 433 429 463 490 521 543 586 618 593 325 344 373 391 416 434 459 489 518 545 571 602 601 614 491 508 436 2008 2009 2010 2011 2012 2013 2014 444 460 492 509 530 525 378 380 402 426 453 402 423 451 463 484 478 315 339 352 379 377 336 352 377 394 403 419 425 380 397 404 406 391 399 402 367 371 389 403 370 384 394 395 400 388 391 396 400 401 411 335 339 338 343 338 315 325 327 331 332 330 308 315 318 327 322 321 301 296 281 293 280 255 257 260 255 251 235 192 181 181 168 157 Source: Assobiomedica Research Centre, Observatory on receivables 37 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS LIGURIA Liguria January February March April May June July August September October November December 38 DSO 2013 178 178 177 168 165 167 169 152 146 141 141 128 DSO 2014 134 132 130 127 125 129 125 123 116 108 103 102 Liguria 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 DSO MIN. 245 200 209 302 293 313 386 305 244 229 225 179 206 DSO MAX 268 281 296 364 353 418 443 475 325 256 258 273 270 Liguria 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 DSO MIN. 208 227 257 270 229 163 154 166 179 179 128 102 DSO MAX 288 265 312 302 314 243 197 178 206 209 178 134 January February March April May June July August September October November December January February March April May June July August September October November December January February March April May June July August September October November December 1990 1991 1992 1993 1994 1995 1996 1997 1998 n.d. n.d. n.d. 268 262 263 267 261 259 254 260 245 253 270 281 281 233 231 257 222 218 212 214 200 209 212 220 217 224 235 257 246 264 283 296 289 302 327 342 342 338 345 364 332 317 319 321 320 338 353 347 327 313 310 322 308 308 318 321 293 313 341 364 383 399 408 418 412 401 398 396 381 397 409 394 391 392 405 425 420 443 394 395 386 407 415 435 444 450 452 475 461 468 410 346 305 302 308 314 312 311 317 325 312 297 301 304 244 1999 2000 2001 2002 2003 2004 2005 2006 2007 256 250 229 233 241 235 237 236 238 242 239 230 240 251 239 244 252 244 242 225 227 230 230 258 265 261 222 267 263 267 273 235 208 210 209 179 206 215 214 216 215 244 245 251 259 266 270 266 275 280 282 278 288 286 282 269 241 253 252 208 236 249 228 227 238 252 265 256 262 261 258 231 257 273 264 278 289 303 310 312 304 306 305 286 302 292 270 280 291 300 299 290 291 298 301 291 310 314 314 312 301 304 309 279 272 256 238 229 2008 2009 2010 2011 2012 2013 2014 243 228 230 217 204 201 199 190 192 185 178 163 188 194 197 193 191 185 178 173 169 167 165 154 174 170 166 166 169 167 178 174 172 169 169 167 179 180 185 200 189 194 205 203 205 206 206 199 209 206 204 203 204 200 206 197 194 187 185 179 178 178 177 168 165 167 169 152 146 141 141 128 134 132 130 127 125 129 125 123 116 108 103 102 Source: Assobiomedica Research Centre, Observatory on receivables 39 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS LOMBARDY Lombardy January February March April May June July August September October November December 40 DSO 2013 105 105 108 107 98 103 104 97 93 96 96 92 DSO 2014 93 94 94 94 88 91 92 84 78 80 80 84 Lombardy 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 DSO MIN. 196 166 181 160 154 143 117 136 162 217 222 241 270 DSO MAX 233 232 203 219 198 199 170 167 235 258 238 262 312 Lombardy 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 DSO MIN. 337 314 261 268 181 138 102 106 94 97 92 78 DSO MAX 373 364 338 295 282 205 156 130 120 120 108 94 January February March April May June July August September October November December January February March April May June July August September October November December January February March April May June July August September October November December 1990 1991 1992 1993 1994 1995 1996 1997 1998 n.d. n.d. n.d. 228 224 229 233 214 215 196 199 197 213 224 219 223 230 217 232 216 208 196 189 166 181 188 181 188 191 191 203 194 193 190 190 186 202 219 201 205 196 202 209 196 187 179 175 160 174 183 184 189 187 187 198 188 186 182 173 154 169 180 185 191 189 191 199 190 175 168 154 143 155 158 163 161 165 168 170 157 147 140 130 117 136 147 145 167 157 159 167 164 150 151 148 140 162 185 197 204 201 219 232 231 234 235 233 226 1999 2000 2001 2002 2003 2004 2005 2006 2007 243 254 247 248 247 249 258 255 239 233 224 217 225 233 224 222 222 233 238 228 232 230 227 229 244 253 257 257 249 252 262 255 247 251 248 241 275 291 270 275 288 308 321 314 301 301 306 312 337 349 361 347 354 362 373 354 355 356 364 343 364 332 314 322 321 328 340 332 334 333 330 317 328 338 296 288 290 295 298 282 272 269 272 261 285 288 268 274 278 284 291 280 282 294 295 268 282 282 277 280 277 273 269 255 241 227 214 181 2008 2009 2010 2011 2012 2013 2014 184 184 190 205 195 196 184 194 175 154 147 138 146 156 138 145 119 115 130 124 109 102 108 104 112 113 119 123 117 123 130 118 118 106 108 108 113 116 118 120 117 114 118 111 107 94 99 113 120 111 112 109 106 107 109 99 97 98 98 98 105 105 108 107 98 103 104 97 93 96 96 92 93 94 94 94 88 91 92 84 78 80 80 84 Source: Assobiomedica Research Centre, Observatory on receivables 41 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS MARCHE Marche January February March April May June July August September October November December 42 DSO 2013 144 144 142 140 124 124 124 89 89 83 91 80 DSO 2014 87 88 93 98 99 94 94 92 85 93 92 78 Marche 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 DSO MIN. 345 356 386 542 366 378 333 343 361 333 329 338 284 DSO MAX 401 406 529 668 681 462 464 374 392 383 362 414 406 Marche 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 DSO MIN. 210 232 214 218 256 122 106 93 116 134 80 78 DSO MAX 337 257 266 279 353 213 161 138 181 168 144 99 January February March April May June July August September October November December January February March April May June July August September October November December January February March April May June July August September October November December 1990 1991 1992 1993 1994 1995 1996 1997 1998 n.d. n.d. n.d. 364 354 349 401 370 377 353 358 345 356 380 386 380 381 373 406 397 359 386 377 362 386 393 392 408 425 441 462 468 486 499 519 529 542 567 567 576 576 586 610 611 627 642 659 668 681 662 664 672 654 610 579 536 479 447 399 366 378 382 383 403 420 436 461 449 448 451 462 444 458 464 455 438 430 438 455 415 418 404 375 333 351 343 363 367 371 369 374 365 362 366 365 357 370 371 368 370 361 373 392 375 379 383 389 368 1999 2000 2001 2002 2003 2004 2005 2006 2007 378 383 373 368 360 357 344 333 343 346 335 349 343 345 343 339 341 344 340 335 329 344 362 361 380 383 392 414 406 395 377 364 360 349 357 338 382 382 361 381 386 411 406 344 289 293 284 284 298 311 321 337 331 294 301 298 281 245 243 210 235 232 240 243 244 250 257 248 243 247 246 240 258 266 244 246 242 245 252 247 250 242 243 214 243 230 219 218 220 237 250 258 261 272 279 275 300 303 306 313 322 342 353 336 335 322 309 256 2008 2009 2010 2011 2012 2013 2014 213 212 210 206 195 193 200 184 188 158 140 122 138 143 152 161 153 153 158 146 155 147 138 106 127 127 133 133 130 129 138 128 118 119 114 93 116 131 143 155 165 172 181 172 177 164 156 157 168 164 160 157 153 155 157 154 154 150 150 134 144 144 142 140 124 124 124 89 89 83 91 80 87 88 93 98 99 94 94 92 85 93 92 78 Source: Assobiomedica Research Centre, Observatory on receivables 43 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS MOLISE Molise January February March April May June July August September October November December 44 DSO 2013 921 914 907 877 856 859 886 880 861 864 835 822 DSO 2014 812 827 838 824 841 854 862 805 754 734 691 641 Molise 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 DSO MIN. 332 321 261 346 405 453 195 214 190 185 179 219 276 DSO MAX 428 473 337 413 531 538 470 289 315 237 220 269 404 Molise 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 DSO MIN. 286 436 510 647 851 530 577 715 771 864 822 641 DSO MAX 451 478 627 912 913 921 676 818 903 934 921 862 January February March April May June July August September October November December January February March April May June July August September October November December January February March April May June July August September October November December 1990 1991 1992 1993 1994 1995 1996 1997 1998 n.d. n.d. n.d. 428 349 366 378 366 374 349 332 372 331 381 338 350 442 439 473 388 407 360 321 321 317 332 320 278 261 288 280 293 319 312 322 337 350 389 422 409 413 392 397 409 375 346 369 386 405 428 447 433 450 476 501 511 524 531 468 435 458 453 477 497 523 522 528 514 492 478 477 511 455 470 341 284 259 253 266 213 223 224 224 195 215 214 232 256 249 267 287 291 269 277 289 273 266 254 256 265 293 300 315 300 289 297 299 190 1999 2000 2001 2002 2003 2004 2005 2006 2007 194 214 213 185 196 216 237 226 213 210 198 222 190 204 189 185 179 201 220 220 209 211 210 218 250 250 262 269 252 255 266 219 233 246 250 237 276 313 315 341 359 404 402 368 345 331 327 324 286 317 365 361 387 428 433 430 419 418 451 386 450 444 436 441 454 468 476 449 448 462 472 478 510 559 577 599 616 627 596 588 599 603 601 599 647 690 733 752 774 777 806 838 832 860 899 912 913 867 851 853 864 871 871 875 885 896 899 906 2008 2009 2010 2011 2012 2013 2014 921 773 788 811 751 668 619 622 624 533 536 530 577 633 664 676 668 582 603 640 636 642 619 619 715 743 775 794 801 800 818 733 735 726 724 763 776 771 786 795 812 830 849 856 873 886 882 903 912 864 888 895 864 880 890 879 917 913 934 875 921 914 907 877 856 859 886 880 861 864 835 822 812 827 838 824 841 854 862 805 754 734 691 641 Source: Assobiomedica Research Centre, Observatory on receivables 45 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS PIEDMONT Piedmont January February March April May June July August September October November December 46 DSO 2013 306 317 327 331 327 331 335 287 273 262 259 222 DSO 2014 232 235 241 239 232 242 243 240 241 231 217 217 Piedmont 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 DSO MIN. 154 150 153 168 145 143 120 124 126 137 171 211 229 DSO MAX 181 207 192 211 187 183 166 157 195 165 215 231 270 Piedmont 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 DSO MIN. 186 197 241 280 237 256 230 228 252 275 222 217 DSO MAX 225 229 274 327 331 281 286 258 284 298 335 243 January February March April May June July August September October November December January February March April May June July August September October November December January February March April May June July August September October November December 1990 1991 1992 1993 1994 1995 1996 1997 1998 n.d. n.d. n.d. 180 168 173 181 164 173 166 154 156 179 181 186 195 192 189 207 191 183 173 161 150 168 169 163 172 181 191 192 183 182 180 172 153 168 191 189 190 189 198 211 198 194 190 187 176 185 180 179 173 174 181 187 176 176 167 158 145 161 167 169 169 170 172 183 180 167 162 153 143 149 147 155 151 155 155 166 165 142 132 131 120 132 142 149 155 148 153 157 149 138 137 134 124 140 148 152 156 174 185 195 187 181 181 181 126 1999 2000 2001 2002 2003 2004 2005 2006 2007 137 140 139 144 149 153 165 154 155 157 163 163 171 182 182 189 192 200 212 200 205 210 211 215 227 216 211 212 222 223 231 224 213 225 225 213 230 236 244 247 247 255 268 270 239 237 232 229 206 212 221 220 212 204 225 211 186 187 190 186 197 201 198 210 215 223 229 216 220 226 227 225 241 271 264 268 260 264 274 269 266 261 268 255 280 281 283 288 289 298 308 292 292 295 312 327 331 237 246 256 256 261 268 254 255 249 257 251 2008 2009 2010 2011 2012 2013 2014 271 281 275 268 263 264 269 264 264 256 267 278 273 278 282 286 282 278 265 253 238 233 239 230 243 238 241 239 242 251 258 252 242 241 246 228 252 261 266 274 274 275 284 280 281 281 278 282 291 294 296 298 290 286 291 289 277 275 283 289 306 317 327 331 327 331 335 287 273 262 259 222 232 235 241 239 232 242 243 240 241 231 217 217 Source: Assobiomedica Research Centre, Observatory on receivables 47 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS PUGLIA Puglia January February March April May June July August September October November December 48 DSO 2013 303 309 312 304 300 292 289 278 256 229 220 204 DSO 2014 214 215 216 213 215 210 211 210 202 198 191 176 Puglia 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 DSO MIN. 451 461 483 563 558 554 530 413 368 372 387 498 516 DSO MAX 512 510 572 686 671 603 632 542 434 400 501 589 584 Puglia 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 DSO MIN. 255 225 180 192 269 313 357 293 285 299 204 176 DSO MAX 510 258 223 255 320 391 422 356 350 358 312 216 January February March April May June July August September October November December January February March April May June July August September October November December January February March April May June July August September October November December 1990 1991 1992 1993 1994 1995 1996 1997 1998 n.d. n.d. n.d. 473 502 502 504 451 512 494 469 467 478 463 488 510 495 461 497 501 496 502 490 478 483 499 498 505 514 512 534 547 552 559 570 572 579 563 628 649 658 674 686 667 659 633 621 623 633 644 649 652 644 656 671 648 631 618 591 558 561 554 555 587 569 583 603 592 603 591 600 581 613 615 623 615 603 609 632 585 588 555 538 530 552 518 537 519 505 506 516 487 460 448 437 413 428 434 432 410 387 388 405 387 384 387 379 368 1999 2000 2001 2002 2003 2004 2005 2006 2007 384 400 397 384 376 372 380 385 379 382 382 388 387 408 421 429 430 432 442 444 458 471 496 505 513 534 547 564 589 571 571 579 579 580 558 498 567 576 555 545 554 573 584 555 534 525 522 516 507 504 510 500 486 458 437 393 341 307 292 255 258 252 237 227 225 240 257 249 253 249 235 232 223 214 190 191 193 196 204 198 203 203 201 180 192 199 203 212 220 233 249 245 236 240 245 255 269 278 289 296 305 305 317 309 317 319 320 294 2008 2009 2010 2011 2012 2013 2014 313 323 333 335 342 356 368 360 364 367 386 391 404 419 422 398 403 412 405 398 408 396 391 357 356 354 351 341 327 333 335 322 332 314 293 312 293 292 295 285 295 305 320 325 332 328 332 350 352 352 356 352 358 349 353 343 342 316 308 299 303 309 312 304 300 292 289 278 256 229 220 204 214 215 216 213 215 210 211 210 202 198 191 176 Source: Assobiomedica Research Centre, Observatory on receivables 49 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS SARDINIA Sardinia January February March April May June July August September October November December 50 DSO 2013 237 240 241 213 217 215 209 205 200 182 166 160 DSO 2014 159 161 163 164 157 160 164 160 147 146 148 145 Sardinia 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 DSO MIN. 317 258 265 324 355 330 242 238 195 193 277 321 355 DSO MAX 366 324 316 431 439 383 376 282 284 276 401 436 386 Sardinia 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 DSO MIN. 332 350 264 250 276 215 214 255 288 243 160 145 DSO MAX 463 401 359 304 337 285 306 317 321 308 241 164 January February March April May June July August September October November December January February March April May June July August September October November December January February March April May June July August September October November December 1990 1991 1992 1993 1994 1995 1996 1997 1998 n.d. n.d. n.d. 351 366 356 344 328 344 351 317 344 324 300 297 303 273 258 294 291 311 277 283 285 290 281 271 265 276 298 296 286 300 298 316 313 324 354 381 381 394 420 425 426 410 421 431 430 439 439 406 391 372 355 380 378 380 384 377 372 383 345 330 350 336 349 366 358 350 361 366 370 376 347 310 291 276 276 289 274 262 252 242 244 251 254 248 251 238 250 265 262 262 271 282 278 274 284 269 244 230 230 243 233 227 229 234 195 1999 2000 2001 2002 2003 2004 2005 2006 2007 206 193 199 204 220 235 235 240 249 256 265 276 277 286 281 291 306 294 327 337 360 379 383 401 414 423 417 427 436 419 399 385 360 328 335 321 355 374 370 366 368 369 378 372 348 366 376 386 387 405 432 436 459 463 453 416 428 422 432 332 401 394 357 354 368 364 379 357 350 355 354 352 352 359 301 325 324 302 318 311 276 272 280 264 250 266 270 268 285 286 299 287 296 304 288 284 294 290 276 287 301 329 337 313 324 321 320 292 2008 2009 2010 2011 2012 2013 2014 280 278 281 282 285 276 266 265 262 247 241 215 214 235 249 247 250 271 276 280 292 289 306 292 298 302 315 317 305 309 308 309 310 291 281 255 288 298 321 316 312 310 315 316 320 321 318 312 297 297 299 308 300 291 277 262 267 268 258 243 237 240 241 213 217 215 209 205 200 182 166 160 159 161 163 164 157 160 164 160 147 146 148 145 Source: Assobiomedica Research Centre, Observatory on receivables 51 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS SICILY Sicily January February March April May June July August September October November December 52 DSO 2013 252 253 253 242 236 234 240 236 236 243 242 237 DSO 2014 254 255 243 248 237 243 245 247 243 249 234 229 Sicily 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 DSO MIN. 344 370 380 459 439 406 411 314 315 304 258 219 243 DSO MAX 415 440 459 529 514 465 494 429 382 352 319 269 268 Sicily 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 DSO MIN. 238 258 250 239 269 260 206 229 277 248 234 229 DSO MAX 304 278 298 283 343 320 235 287 298 299 253 255 January February March April May June July August September October November December January February March April May June July August September October November December January February March April May June July August September October November December 1990 1991 1992 1993 1994 1995 1996 1997 1998 n.d. n.d. n.d. 387 378 408 389 378 415 412 374 344 370 382 401 423 440 418 424 422 420 410 403 391 380 400 403 421 412 422 436 435 450 456 459 455 459 478 496 496 479 503 529 519 521 527 518 502 514 500 492 472 461 464 476 455 455 449 450 439 422 432 412 432 406 415 425 425 433 442 465 463 471 482 488 483 482 488 494 453 455 441 436 411 429 424 419 390 373 364 367 353 334 327 325 314 340 356 373 378 347 368 382 365 368 365 365 315 1999 2000 2001 2002 2003 2004 2005 2006 2007 328 339 349 342 350 347 352 345 326 322 316 304 302 319 306 296 282 284 279 271 270 259 258 255 261 264 265 263 258 261 261 257 246 246 238 224 248 268 263 256 252 253 264 260 260 259 253 243 238 246 245 258 268 266 271 265 265 274 274 304 277 278 267 267 263 266 272 259 261 262 266 258 272 298 262 255 251 259 272 261 250 255 259 251 263 266 244 239 239 247 260 259 266 274 283 277 293 312 335 343 342 307 317 303 300 296 289 269 2008 2009 2010 2011 2012 2013 2014 277 288 292 301 304 318 320 320 316 311 314 260 226 213 210 216 209 208 213 206 224 235 226 215 229 246 246 251 256 258 273 264 267 287 286 264 277 283 283 283 279 278 284 285 288 292 298 296 299 295 289 281 275 277 275 262 262 262 259 248 252 253 253 242 236 234 240 236 236 243 242 237 254 255 243 248 237 243 245 247 243 249 234 229 Source: Assobiomedica Research Centre, Observatory on receivables 53 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS TUSCANY Tuscany January February March April May June July August September October November December 54 DSO 2013 275 264 267 259 257 257 251 229 211 206 205 193 DSO 2014 202 200 201 201 188 192 190 181 175 178 174 169 Tuscany 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 DSO MIN. 306 213 211 290 258 294 229 198 186 198 179 148 173 DSO MAX 374 328 308 321 310 383 373 271 228 226 232 235 200 Tuscany 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 DSO MIN. 196 226 242 193 146 170 188 198 232 241 193 169 DSO MAX 223 270 277 376 210 209 220 261 259 274 275 202 January February March April May June July August September October November December January February March April May June July August September October November December January February March April May June July August September October November December 1990 1991 1992 1993 1994 1995 1996 1997 1998 n.d. n.d. n.d. 329 348 348 358 366 374 366 331 306 298 314 323 328 292 260 265 253 249 240 244 213 211 220 214 223 231 242 274 268 288 296 308 297 299 316 321 316 308 302 313 303 300 302 305 290 295 303 310 289 274 275 274 258 263 271 283 283 294 296 302 328 351 369 383 379 375 372 371 367 373 365 355 351 354 365 368 339 318 266 240 229 238 241 244 245 258 271 271 245 233 215 219 198 198 207 221 214 209 217 228 224 217 216 209 186 1999 2000 2001 2002 2003 2004 2005 2006 2007 198 204 202 206 206 217 226 221 213 213 204 205 213 212 210 213 219 226 232 220 206 197 185 182 199 205 212 228 233 235 213 197 164 153 153 148 179 191 188 195 190 193 200 187 186 177 176 173 195 207 212 207 207 214 239 237 225 221 215 223 258 263 269 267 264 267 270 265 263 258 232 226 242 249 262 266 263 263 277 261 259 260 262 265 298 307 320 325 334 351 376 368 334 300 287 193 204 210 170 164 166 164 169 164 171 165 163 146 2008 2009 2010 2011 2012 2013 2014 170 179 194 201 205 209 200 192 185 177 185 186 199 206 194 197 203 213 220 202 188 189 196 197 215 225 236 236 242 254 261 259 236 210 211 198 232 237 241 247 241 244 254 249 249 255 256 259 270 274 264 261 258 254 253 250 252 241 249 258 275 264 267 259 257 257 251 229 211 206 205 193 202 200 201 201 188 192 190 181 175 178 174 169 Source: Assobiomedica Research Centre, Observatory on receivables 55 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS TRENTINO ALTO ADIGE Trentino A.A. January February March April May June July August September October November December 56 DSO 2013 80 84 81 86 82 80 82 81 80 84 81 78 DSO 2014 84 83 83 84 84 83 83 82 76 74 76 70 Trentino A.A. 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 DSO MIN. 119 127 99 98 101 96 101 98 100 90 107 89 98 DSO MAX 195 155 160 132 130 124 136 137 131 118 120 138 120 Trentino A.A. 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 DSO MIN. 76 65 77 85 92 84 75 75 85 72 78 70 DSO MAX 106 103 117 115 108 106 106 101 100 96 86 84 January February March April May June July August September October November December January February March April May June July August September October November December January February March April May June July August September October November December 1990 1991 1992 1993 1994 1995 1996 1997 1998 n.d. n.d. n.d. 151 195 152 146 125 122 167 126 119 127 132 155 134 142 132 132 129 134 132 129 135 134 137 138 137 138 140 142 133 115 160 117 99 118 121 113 132 131 127 130 120 113 98 111 103 102 118 129 130 124 125 126 116 112 110 108 101 96 101 111 110 119 124 122 120 116 116 106 108 113 126 134 136 136 136 134 116 110 101 101 101 102 114 122 137 128 127 117 111 104 98 102 99 100 113 113 123 131 131 128 114 111 112 128 105 1999 2000 2001 2002 2003 2004 2005 2006 2007 118 118 105 111 105 102 111 104 98 90 106 101 107 120 118 127 117 114 122 112 116 115 120 107 138 119 123 109 106 103 113 108 107 103 100 89 112 120 118 116 111 108 120 112 102 103 106 98 97 97 100 102 102 106 105 93 83 85 84 76 103 93 97 96 96 100 97 96 86 79 79 65 84 117 110 111 103 98 99 94 93 79 86 77 115 97 103 101 97 110 111 101 95 91 93 85 101 97 99 102 103 97 108 101 96 94 96 92 2008 2009 2010 2011 2012 2013 2014 104 104 106 102 101 99 101 94 90 93 93 84 104 98 105 106 102 104 98 99 91 92 95 75 91 91 97 101 96 93 93 91 86 88 91 75 90 95 100 99 98 86 91 89 85 87 90 85 91 95 96 93 91 93 95 89 83 80 79 72 80 84 81 86 82 80 82 81 80 84 81 78 84 83 83 84 84 83 83 82 76 74 76 70 Source: Assobiomedica Research Centre, Observatory on receivables 57 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS UMBRIA Umbria January February March April May June July August September October November December 58 DSO 2013 144 139 135 130 127 135 133 130 134 127 138 131 DSO 2014 140 146 144 142 143 140 135 128 133 123 116 115 Umbria 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 DSO MIN. 211 183 195 286 295 330 261 165 176 234 163 167 219 DSO MAX 265 274 326 333 429 429 404 292 244 287 235 234 261 Umbria 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 DSO MIN. 144 178 174 213 158 127 117 144 144 135 127 115 DSO MAX 230 227 257 272 238 203 161 185 170 176 144 146 January February March April May June July August September October November December January February March April May June July August September October November December January February March April May June July August September October November December 1990 1991 1992 1993 1994 1995 1996 1997 1998 n.d. n.d. n.d. 248 259 265 249 241 239 215 225 211 217 242 240 225 231 267 274 250 225 215 212 183 195 215 206 214 222 234 257 266 289 314 326 317 333 311 304 289 297 295 310 295 303 286 287 288 308 319 301 296 298 315 335 328 299 303 295 310 330 352 375 402 402 420 429 423 412 414 416 406 401 404 379 377 382 382 397 359 321 305 274 261 276 275 282 273 289 279 292 263 267 264 256 165 176 189 193 213 218 235 242 237 244 235 239 221 1999 2000 2001 2002 2003 2004 2005 2006 2007 234 273 262 266 276 287 270 261 261 263 252 244 231 235 228 215 204 208 205 188 197 179 173 163 191 195 192 189 202 213 234 223 195 198 192 167 205 219 214 237 245 249 261 254 225 233 226 219 207 207 211 213 218 221 230 221 182 180 223 144 178 185 190 195 213 224 227 217 208 208 203 193 219 257 250 253 245 235 240 235 221 208 207 174 213 233 249 248 256 259 272 266 271 268 257 216 238 236 226 218 216 221 234 209 224 202 194 158 2008 2009 2010 2011 2012 2013 2014 188 186 188 193 194 195 203 194 178 159 150 127 155 155 159 158 143 161 159 145 142 135 141 117 144 146 161 165 170 179 185 174 163 152 152 150 156 170 164 162 144 154 167 168 165 165 159 149 170 166 170 168 169 170 176 165 161 145 147 135 144 139 135 130 127 135 133 130 134 127 138 131 140 146 144 142 143 140 135 128 133 123 116 115 Source: Assobiomedica Research Centre, Observatory on receivables 59 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS VALLE D'AOSTA Valle D'Aosta January February March April May June July August September October November December 60 DSO 2013 83 88 86 78 78 73 74 73 67 75 65 73 DSO 2014 77 72 68 71 65 71 60 58 78 82 82 73 Valle D'Aosta 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 DSO MIN. 80 68 100 125 96 94 98 77 98 104 117 117 75 DSO MAX 310 191 196 223 173 176 146 141 155 185 171 158 178 Valle D'Aosta 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 DSO MIN. 80 83 104 93 99 103 111 104 106 81 65 58 DSO MAX 128 130 150 135 125 131 132 136 126 116 88 82 January February March April May June July August September October November December January February March April May June July August September October November December January February March April May June July August September October November December 1990 1991 1992 1993 1994 1995 1996 1997 1998 n.d. n.d. n.d. 263 264 288 278 283 310 219 213 80 83 68 79 122 160 176 191 163 94 110 129 101 142 100 124 147 152 170 156 164 186 172 196 193 216 223 185 169 140 155 142 139 162 125 176 125 148 121 164 173 168 152 149 140 113 89 96 97 116 128 160 176 138 122 138 123 114 107 103 94 106 134 110 112 119 131 146 135 123 98 111 111 128 126 108 127 141 128 108 102 120 92 103 77 98 125 131 120 134 155 126 134 143 143 136 129 1999 2000 2001 2002 2003 2004 2005 2006 2007 104 128 130 149 134 164 183 185 159 157 178 166 155 171 138 147 148 117 133 128 120 137 134 128 143 142 158 152 153 137 137 129 129 120 120 117 153 157 123 143 142 178 161 132 100 90 93 75 80 87 112 127 128 142 150 121 128 101 101 97 102 83 101 110 111 125 130 109 92 89 99 84 104 141 148 146 150 136 130 125 108 117 112 119 135 113 114 125 117 110 127 105 93 107 109 101 110 119 111 115 125 122 120 121 114 110 106 99 2008 2009 2010 2011 2012 2013 2014 111 109 117 118 122 131 130 103 117 114 116 112 119 132 117 111 114 111 122 116 112 112 124 131 121 124 130 132 128 115 115 113 118 136 104 105 125 126 109 108 115 108 115 108 108 106 112 106 116 113 106 111 108 105 107 98 89 88 87 81 83 88 86 78 78 73 74 73 67 75 65 73 77 72 68 71 65 71 60 58 78 82 82 73 Source: Assobiomedica Research Centre, Observatory on receivables 61 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS VENETO Veneto January February March April May June July August September October November December 62 DSO 2013 259 262 264 258 254 254 256 242 205 201 201 176 DSO 2014 182 180 173 170 163 161 164 152 127 120 113 105 Veneto 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 DSO MIN. 245 208 209 202 181 168 115 131 174 168 174 167 203 DSO MAX 268 310 286 286 212 224 167 190 219 220 237 212 217 Veneto 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 DSO MIN. 200 216 221 250 227 208 216 237 270 250 176 105 DSO MAX 240 232 261 271 280 263 248 269 288 293 264 182 January February March April May June July August September October November December January February March April May June July August September October November December January February March April May June July August September October November December 1990 1991 1992 1993 1994 1995 1996 1997 1998 n.d. n.d. n.d. 268 262 263 267 261 259 254 260 245 268 267 284 302 303 309 310 294 296 303 301 208 211 210 209 223 234 248 261 260 268 273 286 262 279 286 275 269 254 248 254 237 222 213 213 202 211 212 200 207 191 191 204 196 193 195 194 181 194 200 205 213 209 215 224 217 204 191 173 168 167 158 159 157 159 155 165 161 130 124 116 115 131 137 148 167 169 177 190 180 170 175 157 148 174 192 193 198 195 202 207 207 207 213 219 184 1999 2000 2001 2002 2003 2004 2005 2006 2007 200 208 215 214 212 220 217 209 169 168 207 200 210 220 217 233 237 233 224 221 213 215 194 174 192 197 206 212 207 196 203 181 169 169 172 167 203 217 214 216 217 214 217 207 211 210 217 215 233 240 235 228 224 224 228 226 207 200 203 208 232 226 226 223 218 221 224 218 216 223 228 218 239 261 248 232 224 221 229 228 233 231 235 229 257 260 250 250 251 257 267 259 262 270 271 261 280 276 272 265 257 254 266 248 250 232 232 227 2008 2009 2010 2011 2012 2013 2014 240 248 259 262 261 263 260 253 243 236 236 208 228 238 247 248 240 241 246 240 242 238 242 216 237 251 256 260 260 268 269 262 261 255 260 262 270 276 284 288 283 279 287 287 279 280 275 278 291 292 292 291 289 292 293 259 257 255 258 250 259 262 264 258 254 254 256 242 205 201 201 176 182 180 173 170 163 161 164 152 127 120 113 105 Source: Assobiomedica Research Centre, Observatory on receivables 63 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS ANNEX 3 DSO TABLES PER PUBLIC ENTITY (DECEMBER 2014) REGIONE Denominazione Località P iva ABRUZZO Asl 2 Lanciano - Vasto - Chieti Chieti 02307130696 144 ABRUZZO Asl 1 Avezzano - Sulmona - L'Aquila L'Aquila 01792410662 142 ABRUZZO Asl 3 Pescara Pescara 01397530682 91 ABRUZZO Asl 4 Teramo Teramo 00115590671 83 BASILICATA Azienda Sanitaria Locale Matera 01178540777 177 BASILICATA Asl 1 Venosa Venoza Pz 00628970766 N.D. BASILICATA AO Osp. S. Carlo Potenza 01186830764 88 BASILICATA Azienda Sanitaria Locale Potenza 01722360763 107 CALABRIA Az. Osp. Mater Domini Catanzaro 01991530799 1.459 CALABRIA Az. Osp. Pugliese - Ciaccio Catanzaro 01991520790 718 CALABRIA Azienda Sanitaria Provinciale Catanzaro 02865540799 797 CALABRIA Az. Osp. di Cosenza Cosenza 01987250782 583 CALABRIA Azienda Sanitaria Provinciale Cosenza 02853720783 817 CALABRIA Azienda Sanitaria Provinciale Crotone 01997410798 620 CALABRIA Az. Ospedaliera (B.M.M.) Reggio Calabria Reggio Calabria 01367190806 131 CALABRIA AZIENDA PROVINCIALE Reggio Calabria 02458490808 444 CALABRIA Azienda Sanitaria Provinciale Vibo Valenzia 02866420793 406 CAMPANIA Az. Osp. S. Giuseppe Moscati Avellino 01948180649 147 CAMPANIA Azienda Sanitaria Locale Avellino 02600160648 294 CAMPANIA Az. Osp. G. Rummo Benevento 01009760628 420 CAMPANIA Asl Benevento 1 Benevento 01009680628 N.D. CAMPANIA Az. Osp. S. Sebastiano di Caserta Caserta 02201130610 311 CAMPANIA AZ.SAN.LOC. DI CASERTA Caserta 03519500619 429 CAMPANIA AZ. SAN. LOC. NAPOLI 3 SUD Castellammare di Stabia 06322711216 310 CAMPANIA AZ. SAN. LOC. NAPOLI 2 NORD Monteruscello Pozzuoli 06321661214 367 CAMPANIA Az. Osp. Univ. Federico II Napoli 06909360635 319 CAMPANIA Az. Un. Polic. della II Università Napoli 06908670638 252 CAMPANIA IRCCS I.N.Tumori Fond. G. Pascale Napoli 00911350635 320 CAMPANIA Az. Osp. Cardarelli Napoli 06853240635 414 CAMPANIA A.O.R.N. Azienda Osp. Dei Colli Napoli 06798201213 235 CAMPANIA Az. Osp. Santobono - Pausilipon Napoli 06854100630 222 CAMPANIA AZ. SAN. LOC. NAPOLI 1 CENTRO Napoli 06328131211 622 CAMPANIA SO.RE.SA Napoli 04786681215 149 CAMPANIA Az. Osp. Osp. Riun. S.G Dio-R. D'Aragona Salerno 03020860650 603 CAMPANIA AZ.SAN.LOC. DI SALERNO Salerno 04701800650 400 64 Dic-14 REGIONE Denominazione Località P iva EMILIA ROMAGNA Istituti Ortopedici Rizzoli Bologna 00302030374 101 EMILIA ROMAGNA Az. Osp. Univ. Pol. S. Orsola Malpighi Bologna 02553300373 54 EMILIA ROMAGNA Asl Bologna Bologna 02406911202 103 EMILIA ROMAGNA Asl Cesena Cesena 01254310400 139 EMILIA ROMAGNA Az. Osp. Univ. Arcispedale S. Anna Ferrara 01295950388 172 EMILIA ROMAGNA Asl Ferrara Ferrara 01295960387 117 EMILIA ROMAGNA Asl Forlì Forlì 01959920404 N.D. EMILIA ROMAGNA Asl Imola Imola 00705271203 86 EMILIA ROMAGNA Az. Osp. Policlinico di Modena Modena 02241740360 163 EMILIA ROMAGNA Asl Modena Modena 02241850367 163 EMILIA ROMAGNA Az. Osp. di Parma Parma 01874240342 126 EMILIA ROMAGNA Asl Parma Parma 01874230343 122 EMILIA ROMAGNA Asl Piacenza Piacenza 01138510332 100 EMILIA ROMAGNA Asl Ravenna Ravenna 01277240394 118 EMILIA ROMAGNA Asl della Romagna Ravenna 02483810392 98 EMILIA ROMAGNA Az. Osp. Arcispedale S.Maria Nuova Reggio Emilia 01614660353 104 EMILIA ROMAGNA Asl Reggio Emilia Reggio Emilia 01598570354 120 EMILIA ROMAGNA Asl Rimini Rimini 02329590406 N.D. FRIULI V. G. Asl 3 Alto Friuli Gemona Ud 00825260300 62 FRIULI V. G. Asl 2 Isontina Gorizia 00317460319 102 FRIULI V. G. Asl 5 Bassa Friulana Jalmicco P. Ud 01199500305 94 FRIULI V. G. Az. Osp. S. Maria degli Angeli Pordenone 01302970932 97 FRIULI V. G. Asl 6 Friuli occidentale Pordenone 01278420938 N.D. FRIULI V. G. Centro Riferimento Oncologico Pordenone 00623340932 162 FRIULI V. G. I.R.C.C.S. Burlo Garofalo Trieste 00124430323 120 FRIULI V. G. Az. Osp. Univ. Osp. Riuniti Trieste Trieste 01066380328 60 FRIULI V. G. Asl 1 Triestina Trieste 00052420320 N.D. FRIULI V. G. Azienda Osp. Universitaria S. Maria della Misericordia Udine 02445630300 88 FRIULI V. G. Asl 4 Medio Friuli Udine 01880290307 61 Dic-14 65 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS REGIONE Denominazione Località P iva LAZIO Asl Roma H Albano Laziale Rm 04737811002 146 LAZIO Asl Roma F Civitavecchia Rm 04743741003 229 LAZIO Asl Frosinone Frosinone 01886690609 234 LAZIO Asl Latina Latina 01684950593 154 LAZIO Asl Rieti Rieti 00821180577 143 LAZIO Università Privata CAMPUS BIO MEDICO Roma 04802051005 103 LAZIO Policlinico Universitario Privato Agostino Gemelli Roma 02133120150 300 LAZIO Fondazione PTV Policlinico Tor Vergata Roma 10110821005 103 LAZIO Az. Policlinico Umberto I Rm Roma 05865511009 182 LAZIO Istituti Fisioterapici Ospitalieri Roma 01033011006 179 LAZIO Università La Sapienza Roma 02133771002 N.D. LAZIO Az. Osp. S. Camillo - Forlanini Roma 04733051009 115 LAZIO Az. Osp. S. Filippo Neri Roma 04738701004 139 LAZIO Az. Osp. S. Giovanni - Addolorata Roma 04735061006 222 LAZIO Az. Osp. Sant'Andrea Roma 06019571006 216 LAZIO Asl Roma A Roma 04735671002 108 LAZIO Asl Roma B Roma 04734201009 132 LAZIO Asl Roma C Roma 04739291005 206 LAZIO Asl Roma D Roma 04733491007 159 LAZIO Asl Roma E Roma 04736011000 264 LAZIO I.N.M.I Lazzaro Spallanzani Roma 05080991002 N.D. LAZIO Asl Roma G Tivoli Rm 04733471009 258 LAZIO Asl Viterbo Viterbo 01455570562 133 LIGURIA Asl 4 Chiavarese Chiavari Ge 01038700991 91 LIGURIA IRCCS Istituto Scient.Tumori Genova 01144010103 N.D. LIGURIA IRCCS Az. Osp Univ. San Martino Ist. Genova 02060250996 89 LIGURIA Az. Osp. San Martino Genova 03483570101 72 LIGURIA Ente Osp. Ospedali Galliera Genova 00557720109 158 LIGURIA Asl 3 Genovese Genova 03399650104 97 LIGURIA Istituto Giannina Gaslini Genova Quarto 00577500101 91 LIGURIA Asl 1 Imperiese Imperia 01083060085 101 LIGURIA Asl 5 Spezzino La Spezia 00962520110 80 LIGURIA Asl 2 Savonese Savona 01062990096 84 LOMBARDY Az. Osp. Osp. Riuniti Bergamo Bergamo 00837210160 88 LOMBARDY Asl Provincia di Bergamo Bergamo 02584740167 83 LOMBARDY Asl Vallecamonica Sebino Breno Bs 02072150986 101 LOMBARDY Az. Osp. Spedali Civili Brescia Brescia 01109200178 98 LOMBARDY Asl Provincia di Brescia Brescia 03436310175 N.D. LOMBARDY Az. Osp. Osp.di Circolo Busto Arsizio Busto Arsizio Va 02411080126 84 LOMBARDY Az. Osp. M. Mellini Chiari Bs 01971010986 127 66 Dic-14 REGIONE Denominazione Località P iva LOMBARDY Az. Osp. S. Anna Como Como 02166380135 88 LOMBARDY Asl Provincia di Como Como 02356740130 N.D. LOMBARDY Az. Osp. Osp. Mayre Crema Crema Cr 01151550199 108 LOMBARDY Az. Osp. Istituti Ospitalieri Cremona Cremona 01071310195 78 LOMBARDY Asl Provincia di Cremona Cremona 01150400198 N.D. LOMBARDY Az. Osp. Desenzano del Garda Desenzano del Garda 01972400988 83 LOMBARDY Az. Osp. S. Antonio Abate Gallarate Gallarate Va 02411250125 94 LOMBARDY Az. Osp. G. Salvini Garbagnate Mi 12314450151 70 LOMBARDY Az. Osp. Osp. di Lecco Lecco 02166640132 106 LOMBARDY Asl Provincia di Lecco Lecco 02356390134 N.D. LOMBARDY Az. Osp. Osp. Civile Legnano Legnano Mi 12313480159 76 LOMBARDY Asl Provincia di Milano 1 Legnano Mi 12313930153 72 LOMBARDY Az. Osp. della Prov. di Lodi Lodi 03426440966 75 LOMBARDY Asl Provincia di Lodi Lodi 11387440156 N.D. LOMBARDY Az. Osp. Osp. Carlo Poma Mantova 01736140201 75 LOMBARDY Asl Provincia di Mantova Mantova 01838560207 N.D. LOMBARDY Asl Provincia di Milano 2 Melegnano Mi 12319440157 N.D. LOMBARDY IRCCS Fond. Osp. Mayre Pol. Mang. Regina Milano 04724150968 92 LOMBARDY A.S.P. Golgi Redaelli Milano 04737420150 N.D. LOMBARDY IRCCS Istituto Nazionale Tumori Milano 04376350155 78 LOMBARDY IRCCS Istituto Naz. Neurologico C. Besta Milano 04376340156 81 LOMBARDY Az. Osp. Luigi Sacco Milano 04410920153 71 LOMBARDY Az. Osp. Osp. Niguarda Cà Granda Milano 11390840152 90 LOMBARDY Az. Osp. Ist. Clinici di Perfezionamento Milano 04408300152 123 LOMBARDY Az. Osp. Fatebenefatelli e Oftalmico Milano 11809480152 108 LOMBARDY Az. Osp. S. Paolo Milano 04444150157 115 LOMBARDY Az. Osp. Ist. Ortopedico Gaetano Pini Milano 00903310159 123 LOMBARDY Az. Osp. Osp. S. Carlo Borromeo Milano 11385730152 135 LOMBARDY Asl Città di Milano Milano 12319130154 100 LOMBARDY Az. Osp. S. Gerardo dei Tintori Monza e Brianza 00745800961 87 LOMBARDY Asl Monza e Brianza Monza e Brianza 02734330968 99 LOMBARDY IRCCS Ospedale Policlinico S. Matteo Pavia 00580590180 128 LOMBARDY Az. Osp. della Prov. di Pavia Pavia 01949220188 81 LOMBARDY Asl Provincia di Pavia Pavia 01748780184 70 LOMBARDY Az. Osp. Bolognini Seriate Bg 02585160167 76 LOMBARDY Az. Osp. Valtellina e Valchiavenna Sondrio 00202030144 75 LOMBARDY Asl Provincia di Sondrio Sondrio 00727690141 N.D. LOMBARDY Az. Osp. Osp. Treviglio Caravaggio Treviglio Bg 02585580166 116 Dic-14 67 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS REGIONE Denominazione Località P iva LOMBARDY Az. Osp. di Circolo e Fondazione Macchi Varese 00413270125 108 LOMBARDY Asl Provincia di Varese Varese 02413470127 N.D. LOMBARDY Az. Osp. Osp. Civile Vimercate Vimercate Mi 02733390963 81 LOMBARDY Az. Osp. Osp. di Melegnano VizzoloPredabissi Mi 12319420159 105 MARCHE Az. Osp. Univ. Umberto I Lancisi Salesi Ancona 01464630423 62 MARCHE Az Sanitaria Unica Regionale Ancona 02175860424 79 MARCHE Az. Osp. Ospedali Riuniti Marche Nord Pesaro 02432930416 69 MARCHE Az. Osp. Osp. S. Salvatore Pesaro 01316870417 N.D. MARCHE INRCA Ancona 00204480420 N.D. MOLISE Azienda Sanitaria Reg. Campobasso 01546900703 641 PIEDMONT ASL CN 2 Alba Cn 02419170044 108 PIEDMONT Az. Osp. SS. Antonio Biagio e C. Arrigo Alessandria 01640560064 198 PIEDMONT ASL AT Asti 01120620057 118 PIEDMONT ASL BI Biella 01810260024 135 PIEDMONT ASL AL Casale M.to Al 02190140067 166 PIEDMONT ASL TO 5 Chieri To 06827170017 204 PIEDMONT ASL TO 4 Chivasso To 09736160012 144 PIEDMONT ASL TO 3 Collegno TO 09735650013 275 PIEDMONT Az. Osp. S. Croce e Carle Cuneo 01127900049 134 PIEDMONT ASL CN 1 Cuneo 01128930045 128 PIEDMONT Az. S. O. Ordine Mauriziano Lanzo Torinese To 09059340019 153 PIEDMONT Az. Osp. Mayre della Carità Novara 01521330033 328 PIEDMONT ASL NO Novara 01522670031 183 PIEDMONT ASL VCO Omegna Vb 00634880033 193 PIEDMONT Az. Osp. S. Luigi Gonzaga Orbassano To 02698540016 216 PIEDMONT Azienda Osped. Città della Salute e della Scienza Torino 10771180014 440 PIEDMONT ASL TO 1 Torino 09737640012 150 PIEDMONT ASL TO 2 Torino 09737190018 187 PIEDMONT ASL VC Vercelli 01811110020 179 PUGLIA Azienda Sanitaria BT Andria 06391740724 155 PUGLIA Università degli studi Aldo Moro Bari 01086760723 N.D. PUGLIA Az. Osp. Osp. Policlinico Consorziale Bari 04846410720 226 PUGLIA IRCCS Ospedale Onc Giovanni Paolo II° Bari 00727270720 N.D. PUGLIA Azienda Sanitaria Locale Bari Bari 06534340721 181 PUGLIA Az. Osp. A. di Summa Brindisi 01713790747 N.D. PUGLIA Asl 1 Brindisi Brindisi 01647800745 157 68 Dic-14 REGIONE Denominazione Località P iva PUGLIA IRCCS De Bellis Castellana Grotte Ba 00565330727 N.D. PUGLIA Az. Osp. Osp. Riuniti Foggia Foggia 02218910715 165 PUGLIA Azienda Sanitaria Locale Foggia Foggia 03499370710 270 PUGLIA Azienda Sanitaria Locale Lecce Lecce 04008300750 148 PUGLIA Az. Osp. SS. Annunziata Taranto 02090440732 N.D. PUGLIA Asl 1 Taranto Taranto 02026690731 210 SARDINIA Policlinico Universitario Cagliari Cagliari 02271870921 N.D. SARDINIA Az. Osp. G. Brotzu Cagliari 02315520920 229 SARDINIA Asl 8 Cagliari Cagliari 02261430926 77 SARDINIA Az. Ospedaliero-Universitaria Cagliari 03108560925 129 SARDINIA Asl 7 Carbonia Carbonia Ca 02261310920 123 SARDINIA Asl 4 Lanusei Lanusei Nu 00978060911 N.D. SARDINIA Asl 3 Nuoro Nuoro 00977680917 82 SARDINIA Asl 2 Olbia Olbia Ss 01687160901 227 SARDINIA Asl 5 Oristano Oristano Nu 00681110953 84 SARDINIA Asl 6 Sanluri Sanluri Ca 02265950929 106 SARDINIA Az. Univ. Studi Sassari Pol. Univ. Sassari 02268260904 207 SARDINIA Asl 1 Sassari Sassari 00935650903 191 SICILY Azienda Sanitaria Provinciale Agrigento 02570930848 315 SICILY Azienda Sanitaria Provinciale Caltanissetta 01825570854 162 SICILY Azienda Sanitaria Provinciale Catania 04721260877 329 SICILY Az.Osp.di Ril.Nazionale Alta Sp. Garibaldi-Arnas Catania 04721270876 225 SICILY Azienda Osp. Per l'Emergenza Cannizzaro Catania 04721280875 203 SICILY Az. Osp. Univ. Pol. Vitt. Emanuele Catania 04721290874 297 SICILY Azienda Sanitaria Provinciale Enna 01151150867 288 SICILY Az. Osp. Univ. Polic. G. Martino Messina 03051890832 258 SICILY Azienda Sanitaria Provinciale Messina 03051870834 182 SICILY Azienda Osp. Ospedali Riuniti Papardo-Piemonte Messina 03051880833 363 SICILY IRCCS - Centro Neurolesi Bonino Pulejo Messina 02733700831 N.D. SICILY Azienda Sanitaria Provinciale Palermo 05841760829 235 SICILY Az.Osp.di Ril.Nazionale Alta Sp. Civico-Cristina Palermo 05841770828 244 SICILY Az.Osp. Ospedali Riunti Villa Sofia - Cervello Palermo 05841780827 244 SICILY Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone" Palermo 05841790826 317 SICILY Az. Osp. Civili M.P. Arezzo Ragusa 00980630883 N.D. SICILY Azienda Sanitaria Provinciale Ragusa 01426410880 149 SICILY Az. Osp. O. C. R. Sciacca Sciacca Ag 01965970849 N.D. Dic-14 69 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS REGIONE Denominazione Località P iva SICILY Azienda Sanitaria Provinciale Siracusa 01661590891 250 SICILY Az. Osp. S. Antonio Abate Trapani Trapani 01760600815 N.D. SICILY Azienda Sanitaria Provinciale Trapani 02363280815 172 TUSCANY Asl 8 Arezzo Arezzo 01458450515 126 TUSCANY Asl 11 Empoli Empoli Fi 04616830487 119 TUSCANY Az. Osp. Careggi Firenze 04612750481 211 TUSCANY Az. Osp. Univ. Pol. Meyer Firenze 02175680483 N.D. TUSCANY Asl 10 Firenze Firenze 04612810483 146 TUSCANY AREA VASTA CENTRO Firenze 05577300485 209 TUSCANY Asl 9 Grosseto Grosseto 00315940536 N.D. TUSCANY Asl 6 Livorno Livorno 00615860491 180 TUSCANY Asl 2 Lucca Lucca 00559320460 270 TUSCANY Asl 1 Massa Carrara Massa Carrara 00294690458 109 TUSCANY Fondazione Tuscany Gabriele Monasterio Pisa 01851550507 263 TUSCANY Az. Osp. Univ. Pisana Pisa 01310860505 227 TUSCANY Asl 5 Pisa Pisa 01311020505 336 TUSCANY AREA VASTA NORD OVEST Pisa 01641600505 193 TUSCANY Asl 3 Pistoia Pistoia 01241740479 138 TUSCANY Asl 4 Prato Prato 01683070971 179 TUSCANY Az. Osp. Univ. Senese Siena 00388300527 201 TUSCANY Asl 7 Siena Siena 00388270522 168 TUSCANY AREA VASTA SUD EST Siena 01166590529 183 TUSCANY Asl 12 Viareggio Viareggio Lu 00523180461 122 TRENTINO A. A. Azienda Sanitaria dell'Alto Adige Bolzano 00773750211 70 TRENTINO A. A. Az. Prov. per i Servizi Sanitari Trento Trento 01429410226 58 UMBRIA Azienda Unita Sanitaria Locale Umbria 1 Perugia 03301860544 90 UMBRIA Azienda Unita Sanitaria Locale Umbria 2 Terni 01499590550 127 UMBRIA Az. Osp. di Perugia Perugia 02101050546 61 UMBRIA Az. Osp. S. Maria Terni Terni 00679270553 103 VALLE DI AOSTA Asl Valle d'Aosta Aosta 00177330073 73 VENETO Asl 19 Adria Adria Ro 01013550296 N.D. VENETO Asl 5 Arzignano Arzignano Vi 00913220240 105 VENETO Asl 8 Asolo Asolo Tv 00896810264 89 VENETO Asl 3 Bassano del Grappa Bassano del Grappa 00913430245 83 VENETO Asl 1 Belluno Belluno 00300650256 123 VENETO Asl 22 Bussolengo Bussolengo Vr 02576210237 89 VENETO Asl 14 Chioggia Chioggia Ve 02798310278 131 VENETO Asl 15 Alta Padovana Cittadella Pd 00347610289 99 VENETO Asl 17 Monselice Este Pd 00348220286 79 70 Dic-14 REGIONE Denominazione Località P iva VENETO Asl 2 Feltre Feltre Bl 00300620259 59 VENETO Asl 21 Legnago Legnago Vr 02574230237 105 VENETO Asl 13 Mirano Dolo Mirano Ve 02799530270 87 VENETO Az. Osp. Osp. di Padova Padova 00349040287 114 VENETO Asl 16 Padova Padova 00349050286 162 VENETO Istituto Oncologico Veneto Padova 04074560287 N.D. VENETO Asl 7 Pieve di Soligo Pieve di Soligo Tv 00896790268 54 VENETO Asl 18 Rovigo Rovigo 01013470297 122 VENETO Asl 10 Veneto Orientale S. Donà di Piave Ve 02799490277 156 VENETO Asl 4 Alto Vicentino Thiene Vi 00913490249 79 VENETO Asl 9 Treviso Treviso 03084880263 105 VENETO Asl 12 Veneziana Venezia 02798850273 123 VENETO Az. Osp. Istituti Ospitalieri Verona Verona 02573100233 N.D. VENETO Asl 20 Verona Verona 02573090236 141 VENETO Azienda Osped. Univers. Integrata Verona Verona 03901420236 96 VENETO Asl 6 Vicenza Vicenza 02441500242 124 Dic-14 71 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS ANNEX 4 DSO TABLES PER PRIVATE ENTITY (DECEMBER 2014) REGIONE Denominazione Località P iva ABRUZZO LAB.AN.CLIN.E MICROBIOL.MANTOUX S.N.C. - LANCIANO - CH 01586190694 N.D. ABRUZZO CASA DI CURA PRIVATA PIERANGELI SRL PE 00062520689 228 ABRUZZO Casa Di Cura Villa Serena Srl PE 01220790685 127 ABRUZZO SYNERGO S.R.L. PE 00062520689 323 CALABRIA CASA DI CURA SCARNATI CS 01018540789 N.D. CALABRIA CASA DI CURA VILLA MICHELINO SRL CZ 01473410791 N.D. CALABRIA Villa Sant'Anna Spa CZ 00800680795 333 CALABRIA POLICLINICO MADONNA DELLA CONSOLAZIONE RC 00154270805 N.D. CALABRIA IST. CLINICO PROF.DR. R.DE BLASI SRL RC 00339320806 N.D. CAMPANIA C.D.C. Montevergine S.P.A. AV 00110550647 203 CAMPANIA CASA DI CURA VILLA MARIA SAS AV 01728360643 N.D. CAMPANIA CASA DI C. PRIVATA MALZONI/VILLA DEI PLATANI AV 00126180645 456 CAMPANIA CENTRO ANALISI CLINICHE S.A.S. MONTELLA - AV 01590400642 N.D. CAMPANIA OSP. SACRO CUORE DI GESU' FATEBENEFRATELLI, PROV. REL. DI SAN PIETRO DELL'ORDINE OSPEDALIERO SAN GIOVANNI DI DIO, OSPEDALE BUCCHERI LA FERLA. BN 00894591007 344 CAMPANIA Casa Di Cura San Michele Srl CE 00258670611 237 CAMPANIA CASA DI CURA LA MADONNINA SRL NA 01304701210 N.D. CAMPANIA Villa Dei Fiori S.R.L. NA 00974610636 343 CAMPANIA Clinica Mediterranea Na NA 00271860637 379 CAMPANIA CASA DI CURA NOSTRA SIGNORA NA 01248331215 N.D. CAMPANIA FONDAZIONE EVANGELICA BETANIA NA 06408500632 N.D. CAMPANIA PINETA GRANDE SRL NA 07045161218 200 CAMPANIA CASA DI CURA OSPEDALE INTERNAZIONALE NA 03507900631 N.D. CAMPANIA IST.DIAGNOSTICO VARELLI S.R.L. NA 06028690631 287 CAMPANIA CENTRO DIAGNOSTICO BASILE SRL NA 03171950631 N.D. CAMPANIA CASA DI CURA MARIA ROSARIA S.P.A. - POMPEI - NA 02977901210 N.D. CAMPANIA COLEMAN SPA - ACERRA - NA 02711741211 206 CAMPANIA LABORATORIO S.D.N. SPA NA 01288650631 145 CAMPANIA C.R.C ECOLAB SNC - SORRENTO - NA 01465091211 N.D. CAMPANIA LABORATORIO C. PANDOLFI & C. SAS NA 05072150633 N.D. CAMPANIA Casa Di Cura Privata Salus Spa SA 06553100634 N.D. CAMPANIA Campolongo Hospital Spa SA 00180470650 160 72 Dic-14 REGIONE Denominazione Località P iva Dic-14 CAMPANIA CC.Villa Del Sole Hyppocratica SA 00550600654 N.D. CAMPANIA CASA DI CURA TORTORELLA SA 00741790653 N.D. CAMPANIA LABORATORIO ANALISI CLINICHE LAMBERTI SA 00466730652 N.D. CAMPANIA ANALISI CLINICHE MATER DEI S.R.L. PAGANI - SA 02223270659 N.D. CAMPANIA DIAGNOSTICA CAVALLO S.R.L. - SALERNO - SA 01112760655 N.D. EMILIA-ROMAGNA Casa Di Cura M. Fortunata Toniolo BO 00427050232 98 EMILIA-ROMAGNA Casa Di Cura Prof. Nobili SpA BO 00519601207 N.D. EMILIA-ROMAGNA Casa di Cura Villa Laura s.r.l. BO 02378901207 31 EMILIA-ROMAGNA CASA DI CURA VILLA CHIARA BO 00503971202 61 EMILIA ROMAGNA CASA DI CURA VILLA ERBOSA (GRUPPO SAN DONATO) BO 00312830375 190 EMILIA-ROMAGNA Casa Di Cura Villa Serena Spa FC 00376360400 115 EMILIA-ROMAGNA CDC PRIV. MALATESTA NOVELLO SRL FC 00377720404 N.D. EMILIA-ROMAGNA Eurosets Srl (Gruppo Villa Maria) MO 02005430364 N.D. EMILIA-ROMAGNA Ospedale di Sassuolo S.p.A. MO 02815350364 72 EMILIA-ROMAGNA Hesperia Hospital S.p.A. MO 01049620360 171 EMILIA-ROMAGNA Casa Di Cura Citta' Di Parma S.P.A. PR 00305320343 155 EMILIA ROMAGNA HOSPITAL PICCOLE FIGLIE SRL PR 00306740341 N.D. EMILIA-ROMAGNA C.C. Villa Maria Cecilia RA 00178460390 N.D. EMILIA-ROMAGNA KRONOSAN S.R.L. RA 08906470151 249 EMILIA-ROMAGNA CASA DI CURA VILLA VERDE RE 00294320353 111 EMILIA-ROMAGNA Casa Di Cura Villa Maria Spa RN 00370290405 86 EMILIA-ROMAGNA C.D.C. Sol Et Salus RN 00432390409 44 EMILIA-ROMAGNA CDC PRIVATA PROF E. MONTANARI SPA RN 00413900408 N.D. FRIULI Policlinico Triestino s.r.l. TS 00139620322 N.D. FRIULI CASA DI CURA CITTA' DI UDINE SPA UD 00158790303 118 LAZIO Casa Di Cura Sant'Anna Srl FR 00627760606 N.D. LAZIO Casa Del Sole S.R.L. LT 01298500594 N.D. LAZIO CASA DI CURA CITTA' DI APRILIA LT 00168290591 N.D. LAZIO Casa Di Cura Sant'Anna RM 01998571002 N.D. LAZIO ITALIA HOSPITAL S.P.A. RM 05780911003 208 LAZIO Dolomiti S.P.A. RM 01148721002 N.D. LAZIO European Hospital RM 01774941007 486 LAZIO Rome American Hospital S.P.A. RM 01739301008 N.D. LAZIO Casa Di Cura Mater Dei S.P.A. RM 01847211008 N.D. LAZIO Le Cure Cliniche Moderne Srl RM 01188071003 N.D. LAZIO Fiducia S.R.L. RM 05185971008 N.D. LAZIO CDC Villa Valeria S.r.l. RM 01032551002 N.D. LAZIO C.D.C. San Feliciano RM 00958671000 N.D. LAZIO Casa di Cura Villa Mafalda S.p.A. RM 00858841000 N.D. LAZIO Villa Margherita S.p.A. RM 01007401001 N.D. 73 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS REGIONE Denominazione Località P iva LAZIO GIOMI S.P.A. RM 06619881003 619 LAZIO NUOVA CLINICA ANNUNZIATELLA S.R.L. RM 05066941005 N.D. LAZIO CDC VILLA PIA RM 00967051004 N.D. LAZIO CASA DI PROCURA GENERALIZIA DELL'ISTITUTO DELLE SUORE DI SAN GIUSEPPE DI GERONA RM 01001021003 N.D. LAZIO CASA REGINA APOSTOLORUM DELLA PIA SOCIETA' DELLE FIGLIE DI SAN PAOLO RM 05195071005 N.D. LAZIO IRCCS SANTA LUCIA RM 05692831000 241 LAZIO IRCCS SAN RAFFAELE PISANA RM 08253151008 N.D. LAZIO IDI IRCCS PROV. IT. CONGR. FIGLI DELL IMMACOLATA CONCEZIONE, PROV. IT. CONGR.FIGLI DELL IMM CONC OSP. S CARLO DI NANCY, IDI IRCCS VILLA PAOLA RM 00988411005 2811 LAZIO OSPEDALE PEDIATRICO BAMBIN GESU' RM 80403930591 231 LAZIO OSPEDALE GENERALE DI ZONA "SAN GIOVANNI CALIBITA" RM 00989031000 1591 LAZIO ISTITUTO FIGLIE DI NOSTRA SIGNORA AL MONTE CALVARIO "CRISTO RE" RM 01067031003 N.D. LAZIO OSPEDALE ISRAELITICO RM 02133341004 181 LAZIO POLICLINCO PORTUENSE SPA RM 00905701009 347 LAZIO A.C.I.S.M.O.M. RM 00995661006 721 LAZIO A.D.I. ACCENTRAMENTO DIAGNOSTICO - CASAL MONASTERO - RM 01133501005 N.D. LAZIO ALLIANCE MEDICAL DIAGNOSTIC S.R.L. RM 02846000616 192 LAZIO ANALISI CLINICHE D.PIZZO E SALVATORI SRL RM 00988181004 N.D. LAZIO ARTEMISIA S.P.A. RM 00929551000 N.D. LAZIO AURELIA 80 S.P.A. RM 01239831009 718 LAZIO B.& S. SERVIZI SANITARI SRL RM 04977641002 N.D. LAZIO BIOS PREVENTION S.R.L. RM 12430111000 N.D. LAZIO BIOS S.P.A. RM 01014021008 129 LAZIO CASA DI CURA VILLA BETANIA RM 01084871001 339 LAZIO CASA DI CURA PAIDEIA SPA RM 01847201009 N.D. LAZIO EUROSANITA' SPA RM 06726891002 484 LAZIO FE.NI.G. S.R.L. RM 01137951008 N.D. LAZIO ISTITUTO ANALISI CLINICHE I.A.C. S.R.L. - OSTIA LIDO - RM 01553881002 N.D. LAZIO LAB. ANALISI CLIN. ALESSANDRINI SRL RM 01330781004 N.D. LAZIO MARILAB S.R.L. - OSTIA LIDO - RM 01233441003 N.D. LAZIO MEDICAL PRODUCTS SRL RM 06017211001 727 LAZIO METAMED S.R.L. RM 11181911006 N.D. LAZIO PRAXIMEDICA S.R.L. RM 01319331003 N.D. LAZIO RM 81 S.P.A. RM 01353181009 148 LAZIO SALUS INFIRMORUM RM 01442520696 N.D. 74 Dic-14 REGIONE Denominazione Località P iva Dic-14 LAZIO SAN FELICE S.R.L. RM 01302791007 N.D. LAZIO SERVIZI DIAGNOSTICI S.R.L. RM 07246691005 218 LAZIO V&V MEDICAL S.R.L. RM 04238541009 N.D. LIGURIA Casa di Cura Montallegro GE 00967100108 N.D. LIGURIA ICLAS S.R.L. GE 00201380995 N.D. LIGURIA VILLA SERENA SPA GE 00262530108 N.D. LIGURIA OSPEDALE EVANGELICO INTERNAZIONALE GE 00656740107 134 LIGURIA BIO-DATA S.R.L. - LAVAGNA GE 00174920991 N.D. LOMBARDY Clinica Castelli Spa BG 00455110163 N.D. LOMBARDY CONGREGAZIONE SUORE DELLE POVERELLE - ISTITUTO PALAZZOLO BG 00533470167 101 LOMBARDY CASA DI CURA SAN FRANCESCO BG 00564560100 81 LOMBARDY POLICLINICO SAN MARCO (GRUPPO SAN DONATO) BG 01758140162 239 LOMBARDY POLICLINICO SAN PIETRO (GRUPPO SAN DINATO) BG 00468460167 N.D. LOMBARDY LE CLINICHE GAVAZZENI SPA BG 00468520168 98 LOMBARDY DOMUS SALUTIS CONGREGAZIONE SUORE - ANCELLE DELLA CARITA' BS 03375240177 N.D. LOMBARDY FONDAZIONE POLIAMBULANZA ISTITUTO OSPEDALIERO BS 02663120984 134 LOMBARDY ISTITUTO CLINICO CITTA' DI BRESCIA SPA (GRUPPO SAN DONATO) BS 00585540172 184 LOMBARDY ISTITUTO CLINICO SANT'ANNA (GRUPPO SAN DONATO) BS 00298670175 152 LOMBARDY ISTITUTO CLINICO SAN ROCCO (GRUPPO SAN DONATO) BS 03141990170 182 LOMBARDY SYNLAB ITALIA SRL - BRESCIA BS 00577680176 116 LOMBARDY Lanzo Hospital S.p.A. CO 00192700136 133 LOMBARDY ISTITUTO CLINICO VILLA APRICA SPA (GRUPPO SAN DONATO) CO 00226780138 158 LOMBARDY OSP. GEN. ZONA VALDUCE CO 00278770136 278 LOMBARDY ASSOCIAZIONE LA NOSTRA FAMIGLIA, ISTITUTO SCIENTIFICO MEDEA BOSISIO P. LC 00307430132 N.D. LOMBARDY MEDICAL GAMMA S.N.C. LAB.ANALISI MEDICHE - CODOGNO - LO 03431430150 N.D. LOMBARDY ISTITUTI CLINICI ZUCCHI (GRUPPO SAN DONATO) MB 00697570968 125 LOMBARDY C.A.M. CENTRO ANALISI MONZA SPA MB 00701390965 97 LOMBARDY CDC La Madonnina S.p.A. MI 00866980154 108 LOMBARDY EMO GVM CENTRO CUORE COLUMBUS SRL MI 07993660153 N.D. LOMBARDY IRCCS S.GIOVANNI DI DIO - FBF MI 01647730157 528 LOMBARDY CENTRO CARDIOLOGICO MONZINO SPA MI 13055640158 167 LOMBARDY DIAGNOSTICA E RICERCA SAN RAFFAELE MI 13168120155 100 LOMBARDY BIANALISI SRL MI 00731780961 92 75 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS REGIONE Denominazione Località P iva LOMBARDY VE.DI. SRL MI 01864140155 N.D. LOMBARDY CASA DI CURA SAN CAMILLO MI 06532810964 185 LOMBARDY IRCCS OSPEDALE SAN RAFFAELE (GRUPPO SAN DONATO) MI 05592661002 205 LOMBARDY CASA DI CURA IRCCS S.M.NASCENTEFOND.DON C.GNOCCHI MI 12520870150 75 LOMBARDY ISTITUTO CLINICO HUMANITAS MI 10125410158 173 LOMBARDY ISTITUTO CLINICO SANT'AMBROGIO E SAN SIRO (GRUPPO SAN DONATO) MI 00858290158 155 LOMBARDY ISTITUTO EUROPEO DI ONCOLOGIA MI 08691440153 155 LOMBARDY I.R.C.C.S. POLICLINICO SAN DONATO SPA (GRUPPO SAN DONATO) MI 05853360153 273 LOMBARDY I.R.C.C.S. ISTITUTO ORPTOPEDICO GALEAZZI SPA (GRUPPO SAN DONATO) MI 05849220156 270 LOMBARDY MULTIMEDICA HOLDING SPA MI 13384540152 N.D. LOMBARDY POLICLINICO DI MONZA CASA DI CURA PRIVATA SPA, ISTITUTO CLINICO SANTA RITA SPA. MI 11514130159 550 LOMBARDY IRCCS CASA DI CURA MULTIMEDICA S.P.A. MI 06781690968 466 LOMBARDY ISTITUTO CLINICO CITTA' STUDI S.P.A. MI 09444340153 137 LOMBARDY ISTITUTO AUXOLOGICO ITALIANO MI 02703120150 144 LOMBARDY CLINICA SAN CARLO CASA CURA PRIVATA - PADERNO DUGNANO - MI 02061970964 170 LOMBARDY CASA DI CURA IGEA S.P.A. MI 02031760156 54 LOMBARDY CDI CENTRO DIAGNOSTICO ITALIANO S.P.A. MI 01721030151 88 LOMBARDY FLEMING RESEARCH S.R.L MI 04962000156 101 LOMBARDY OSPEDALE CIVILE DI VOLTA MANTOVANA SRL MN 02069430201 N.D. LOMBARDY OSPEDALE DI SUZZARA SPA MN 04482440965 181 LOMBARDY FOND.IST.NEUROL.C.MONDINO PV 00396070187 N.D. LOMBARDY FONDAZIONE SALVATORE MAUGERI CLINICA DEL LAVORO E DELLA RIABILITAZIONE PV 00305700189 362 LOMBARDY ISTITUTO CLINICO PROF. E. MORELLI (GRUPPO SAN DONATO) PV 00303270185 N.D. LOMBARDY ISTITUTO CLINICO BEATO MATTEO (GRUPPO SAN DONATO) PV 08086250159 N.D. LOMBARDY ISTITUTO DI CURA CITTA' DI PAVIA (GRUPPO SAN DONATO) PV 00182770180 193 LOMBARDY LAB. ANALISI MEDICHE S.GIORGIO SRL - SAN GENESIO ED UNITI - PV 00834060188 N.D. LOMBARDY Ist. Clinico Mater Domini C.D.C. VA 00340810126 121 LOMBARDY TOMA ADVANCED BIOMEDICAL ASSAYS S.P.A. - BUSTO ARSIZIO - VA 00772010120 64 MARCHE LAB. ANALISI CHIMICO CL. DEL PIANO SRL AN 00235150422 N.D. MARCHE LABOR SPA CASA DI CURA VILLA IGEA AN 00204460422 N.D. 76 Dic-14 REGIONE Denominazione Località P iva Dic-14 MARCHE CASA DI CURA VILLA SAN MARCO AP 00210190443 N.D. MARCHE CASA DI CURA VILLA VERDE FM 00220340442 N.D. MARCHE SALUS MEDICA SRL PU 02246030411 N.D. MOLISE CASA DI CURA VILLA ESTHER DI FORTE ELISA CB 00060750700 N.D. MOLISE FONDAZIONE DI RICERCA E CURA GIOVANNI PAOLO II CB 01660990704 358 MOLISE NEUROMED I.R.C.C.S. IS 00068310945 451 PIEDMONT CDC PRIVATA CITTA' DI BRA S.P.A. CN 01118370046 87 PIEDMONT CASA DI CURA I CEDRI SPA NO 01337620031 N.D. PIEDMONT PROMEA SPA - DAY SURGERY TO 08029290015 N.D. PIEDMONT Ecas Spa Casa Di Cura Fornaca TO 01737940013 N.D. PIEDMONT Casa Di Cura Cellini S.P.A. TO 00510380017 134 PIEDMONT Pro Infantia SpA TO 01090120013 116 PIEDMONT FONDAZIONE DEL PIEDMONT PER L'ONCOLOGIA TO 97298700150 N.D. PIEDMONT PICCOLA CASA DELLA DIVINA PROVIDENZA OSP. COTTOLONGO TO 01538340017 N.D. PIEDMONT PRESIDIO BEATA VERGINE CONSOLATA TO 11586340457 N.D. PIEDMONT PRESIDIO OSPEDALIERO OSPEDALE GRODENIGO TO 01097260010 112 PIEDMONT L.A.M.A.T. S.R.L.- LAB. ANALISI CLINICHE TO 00951610013 N.D. PIEDMONT CENTRO DIAGNOSTICO CERNAIA S.P.A. TO 03784000014 194 PIEDMONT LABOR.MEDICO "CESARE BATTISTI" SAS - CHIERI - TO 01409390018 N.D. PIEDMONT RAFFAELLO S.R.L. LABORATORIO ANALISI MEDICHE TO 00709170013 N.D. PIEDMONT Centro Ortopedico Di Quadrante VB 01875380030 73 PUGLIA Cdc S. Maria Spa Bari BA 00597760727 236 PUGLIA CASA DI CURA PROF. PETRUCCIANI BA 01813160759 N.D. PUGLIA CBH CITTA DI BARI HOSPITAL SPA BA 05498020725 1287 PUGLIA OSPEDALE GENERALE REGIONALE F. MIULLI BA 00574290722 1035 PUGLIA CONGREGAZIONE REL. SUORE ANCELLE DIVINA PROVVIDENZA BA 02519530725 N.D. PUGLIA FOND. CASA SOLLIEVO DELLA SOFFERENZA OSPEDALE FG 00138660717 258 PUGLIA CASA DI CURA RIUNITE VILLA SERENA E NUOVA SAN FRANCESCO SRL FG 00368500716 N.D. PUGLIA PIA FOND.DI CULTO E RELIGIONE LE 02616050759 324 PUGLIA LABORATORIO DOTT.PASQUALE PIGNATELLI S.R.L. LE 01143150751 592 PUGLIA CASA DI CURA S. CAMILLO SRL TA 00273480731 N.D. PUGLIA Casa Di Cura Villa Verde TA 00943900738 138 PUGLIA Casa Di Cura Bernardini S.R.L. TA 00601480742 N.D. 77 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS REGIONE Denominazione Località P iva PUGLIA SAN RAFFAELE CITTADELLA DELLA CARITA' TA 01051420733 N.D. SARDINIA CASA DI CURA MADONNA DEL RIMEDIO CA 00439710922 N.D. SARDINIA C.D.R. LABORATORIO ANALISI MED. NUCLEARE SAS CA 01060190921 N.D. SICILY LAB.AN.CLINICHE VITO MANNINA SRL AG 02205530849 N.D. SICILY Sia Casa Di Cura S. Anna S.p.A. AG 00137210845 N.D. SICILY Centro Clinico e Diagnostico CT 00248620874 467 SICILY LINEA BLU DIAGNOSTICI SRL - SAN GIOVANNI LA PUNTA - CT 04879960872 N.D. SICILY LABORATORI RIUNITI SANTA TERESA SRL - PALAGONIA - CT 04791210877 N.D. SICILY OSPEDALE ASSOCIAZIONE OASI MARIA SANTISSIMA IRCCS EN 00102160868 N.D. SICILY PROVINCIA SICULA CC.RR.M.I ME 00191770833 N.D. SICILY Casa Di Cura Cristo Re ME 00191850833 N.D. SICILY Casa di Cura Villa Salus ME 01379750837 339 SICILY CASA DI CURA CARMONA S.R.L. ME 01428290892 N.D. SICILY Ismett PA 04544550827 68 SICILY C.D.C. Noto Pasqualino S.R.L. PA 00712600824 N.D. SICILY CASA DI CURE ORESTANO Srl PA 00295440820 N.D. SICILY FONDAZIONE INSTITUTO SAN RAFFAELE OSPEDALE G. GIGLIO DI CEFALU' PA 05205490823 270 SICILY CONSORZIO TRISCELE SCARL - PARTINICO - PA 05767970824 N.D. SICILY LAB. ANALISI CLINICHE DR.BALISTRERI - BAGHERIA - PA 04713570820 N.D. SICILY CASA DI CURA CANDELA SPA PA 00118410828 N.D. SICILY CASA DI CURA MACCHIARELLA SPA PA 00301520821 N.D. SICILY LABORAT.DI RICERCHE LOCOROTONDO PA 02434030827 N.D. SICILY LABORATORY SERVICE PA 05489930825 N.D. SICILY CDC Cura Villa Azzurra S.R.L. SR 00904300894 N.D. SICILY ISTITUTO ORTOPEDICO VILLA SALUS SR 01552710897 290 TUSCANY SAN GIUSEPPE HOSPITAL AR 08531211004 476 TUSCANY VALDISIEVE HOSPITAL SRL FI 00639790484 163 TUSCANY Casa Di Cura Villa Donatello S.P.A. FI 00393590484 151 TUSCANY CENTRO ONCOLOGICO FIORENTINO FI 00932450489 101 TUSCANY HC HOSPITAL CONSULTING SPA LOC GRASSINA FI 03010380487 160 TUSCANY RICERCHE CL.PR.MANFREDO FANFANI SAS FI 01768030486 N.D. TUSCANY IST.FIORENTINO DI CURA E ASSISTENZA SPA FI 01300810486 220 TUSCANY FONDAZIONE STELLA MARIS IRCCS PI 00126240506 N.D. TUSCANY CASA DI CURA SAN ROSSORE S.R.L. PI 00125720508 N.D. TUSCANY CASA DI CURA VILLA FIORITA SRL PO 00336980974 63 TUSCANY CASA DI CURA RUGANI S.R.L. SI 01243020524 166 78 Dic-14 REGIONE Denominazione Località P iva Dic-14 UMBRIA CDC Liotti S.p.A. PG 01678940543 N.D. UMBRIA Casa di Cura Elledue s.r.l. PG 02253190546 N.D. VENETO CASA DI CURA ABANO TERME PD 01735030684 130 VENETO RDI S.R.L. RETE DIAGNOSTICA ITALIANA - LIMENA - PD 04296540281 128 VENETO CASA DI CURA VILLA MARIA SRL - PD 00669200289 N.D. VENETO DATA MEDICA PADOVA S.P.A. PD 00477060289 N.D. VENETO CLINICA VETERINARIA S.MARCO SRL PD 03313150280 N.D. VENETO CDC Privata S.M.Maddalena SpA RO 00119690295 169 VENETO OSPEDALE GENERALE DI ZONA SAN CAMILLO, ISTITUTO SAN CAMILLO ROMA. TV 01008231001 179 VENETO POLICLINICO SAN MARCO S.P.A. VE 00347320277 126 VENETO OSPEDALE VILLA SALUS OSP. GEN. DI ZONA VE 00336090477 388 VENETO I.R.C.C.S. OSPEDALE 'S.CAMILLO' VE 01556270153 N.D. VENETO L.A.M.M. S.R.L.-LAB.ANALISI MEDICHE - MESTRE - VE 00397910274 N.D. VENETO Casa Di Cura Eretenia S.P.A. VI 00444840243 96 VENETO CDC Villa Berica S.p.A.. VI 02933770246 N.D. VENETO C.D.C. Pederzoli VR 00233020239 58 VENETO OSPEDALE SACRO CUORE VR 00280090234 133 79 AVERAGE PAYMENT TIME FOR PRIVATE AND PUBLIC HEALTH ORGANISATIONS Data and information in this document may be transcribed by a third party provided that the reference is acknowledged: Guglieri A., Carbone S. (2015), Avarage payment times of public and private healthcare organisations. 2014 and prior years. Assobiomedica Research Centre, Studies N.31, May 2015. ASSOBIOMEDICA RESEARCH CENTRE Via Marostica, 1 - 20146 Milan - Ph. +39 02.34531165 - Fax +39 02.34592072 E-mail: [email protected]