All articles by Mitroshin P. V.
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2023 № 6 Payment methods for primary health care, specialized (including high-tech) medical care in the compulsory health insurance system: the logic of the most urgent changes in the tariff policy of 2023.
The article discusses new methodological approaches to the methods of paying for medical care in the compulsory medical insurance system for 2023, including those approved by recently issued regulatory legal acts, as well as joint recommendations of the Ministry of Health of Russia and the Federal Compulsory Medical Insurance Fund (FOMS).
The article analyzes the main reasons for changes in the tariff policy and their expected consequences in terms of increasing the motivation of medical organizations.
It is noted that there is a need to revise the remuneration systems of employees of medical organizations (primarily state and municipal) in order to more closely link incentive payments with performance indicators used in determining the amount of payment for medical care, which is intended to become an important motivation tool for improving the availability and quality of primary health care and, as a consequence, reducing the need for specialized medical care.
An overview of innovations in the payment of high-tech medical care is given. -
2022 № 6 Changes in the procedure for carrying out control measures in the compulsory health insurance system in 2022
One of the most important innovations in the system of compulsory medical insurance in 2021 was the change in the order of control measures. At the same time, both the participants of the MHI system, who have the authority to conduct control measures, and the procedure for conducting control have changed.
This paper analyzes the next, rather voluminous changes in the system of control measures that occurred already in 2022. An assessment of the impact of these changes on the effectiveness of control and on the work of medical organizations is given. -
2021 № 5 New system of control measures in relation to medical organizations within the framework of compulsory health insurance
One of the most serious innovations in the system of compulsory health insurance is the change in the procedure for conducting control measures. In accordance with the new version of Federal Law No. 326-FZ (in accordance with the provisions of the Federal Law of December 8, 2020 № 430-FZ On Amendments to the Federal Law "On Compulsory Medical Insurance in the Russian Federation"), the procedure for monitoring the volume, timing, quality and conditions of providing medical care for compulsory medical insurance to insured persons, as well as its financial support, is now established not by the Federal Fund for Compulsory Medical Insurance, but by the Ministry of Health of the Russian Federation. At the same time, both the participants of the CMI system who have the authority to conduct control measures, and the procedure for conducting control, are changing.