According to the Czech Medical Chamber, reimbursements from health insurance companies decreased for approximately one quarter of gynecological clinics last year. Starting this year, clinics receive an aggregated monthly payment per registered patient instead of payment per individual procedure, amounting to approximately 1,400 crowns annually, with possible bonuses up to 1,932 crowns. This system is beneficial for 72 percent of clinics, especially large ones, but facilities with two thousand or fewer patients are losing money under the new system. According to a Czech Medical Chamber representative, the aggregated payment is insufficient for repeated ultrasound examinations, which is why many gynecologists offer patients the option to pay 500 crowns out-of-pocket for ultrasounds. Gynecology represents approximately 1.3 percent of total public health insurance costs, which will exceed 600 billion crowns next year. Gynecologists' representatives confirmed this payment method for 2027 as well, with the maximum monthly amount per registered patient increasing from 160 to 165 crowns.