Articles with tag: «mandatory medical insurance»
2017 № 10 Financial reserves of the state (municipal) institutions health
. The difficult economic situation makes to search for possible variants of optimization of resources and reserves in the state (municipal) institutions. Many heads of agencies believe that the reserves for salary increases in accordance with the «Мay» decrees of the President have been exhausted. However, they did not start the process of normalization, the introduction of professional standards and effective contracts. On the other hand, the legal environment in which agencies are often not allowed to implement the legislation provided for the possibility of attracting additional resources. These issues are discussed in this publication
2020 № 1 Health care Financing in 2020: priorities within the national project «Health Care»
Analysis of future health financing shows that in 2020–2022, despite the difficult financial situation, the growth of financial support for the health system will continue. Among the priorities for 2020, we should highlight the increase in funding for cancer care. This is the implementation of the provisions of the Decree of the President of the Russian Federation on may 7, 2018 No. 204 "on national goals and strategic objectives of the development of the Russian Federation for the period up to 2024". The allocation of funds in the compulsory health insurance system is also based on these priorities. In particular, at the expense of mandatory medical insurance funds, financial incentives are provided for employees to identify oncological disease. Among the positive aspects are inter-budget transfers to the budget of the compulsory health insur¬ance Fund from the Federal budget to pay for high-tech medical care that is not included in the basic program mandatory medical insurance and birth certificates. All this should have a positive impact on the further development of health care.
2020 № 8 Changes in the procedure for financial support of medical organizations in the system of compulsory medical insurance at the present stage of the spread of coronavirus infection
In the context of the spread of coronavirus infection, the main problem of medical organizations is not an obvious increase in the cost of providing medical care associated with ensuring the sanitary and epidemiological regime (personal protective equipment, disinfection, etc.), but a decrease in income due to a drop in the volume of planned medical care, suspension of preventive measures, downtime (during the period of re-profiling, etc.).
The state quickly responded to this situation by making changes to the relevant legislation and adopting a number of special regulatory legal acts. However, the implementation of these rather varied measures tied to a number of factors, such as the presence or absence of restrictive measures on the territory of the Russian Federation; participation or non-participation in the care of patients with coronavirus infection; periods within which the one or the other order advances, etc.
All this causes difficulties in understanding what financial security mechanism is applied to this particular situation, what should be the actions of medical organizations.
This article is devoted to the analysis of ways of financial support of medical organizations in the system of compulsory medical insurance at various stages of the fight against coronavirus infection.
2016 № 7 The possibilities of use of OSDs funds financing for the drug supply in the provision of medical care for patients with rare diseases
The article analyzes the possibilities of use of means of obligatory medical insurance for drug supply patients with rare (orphan) diseases in the provision of medical care in hospital and day hospital.
2015 № 5 Issues related to utilizing standards of medical aid in the mandatory medical insurance system
The article is dedicated to analysis of legislation, other normative acts, related to application of regulations on providing medical aid and standards of medical aid, medical aid quality control and enforcement of penalty sanctions towards medical organizations in the system of mandatory medical insurance.
2014 № 8 An analysis of possible consequences from introduction of co-payments from unemployed population into the system of mandatory medical insurance (Federal Research Institute for Health Care Organization and Information of the Ministry of Health Care and Social Development of Russian Federation, Moscow)
In accordance with the current legislation, employers are obligated to cover expenses for mandatory medical insurance system. Constituent territories of Russian Federation are responsible for making payments to support unemployed population (children and elderly and as such). Ministry of Finance of Russia suggested to introduce a mechanism in accordance to which the unemployed population (with exceptance of certain categories) would be responsible for covering expenses for mandatory medical insurance system themselves. The article is dedicated to an analysis of consequences of establishing proposals of Russian Ministry of Finance with regards to introducing co-payments into the system of mandatory medical insurance.
2014 № 2 Problems of financial provision of high-tech medical aid (Federal Research Institute for Health Care Organization and Information of the Ministry of Health and Social Development of Russian Federation, Moscow)
Annotation: In accordance with legislation the high tech medical aid is gradually transferred into the system of mandatory medical insurance. However, the mechanism of organizing the high tech medical aid in the system of mandatory medical insurance, as well as the order of financial provision and etc. remain till now unclear. This material is dedicated to the analysis of problems related to the issues above and to a review of suggested approaches in solving them.
2015 № 6 The need for more continuity and cooperation the relationship between quality of medical care in the mandatory medical insurance system and control of quality and safety of medical activities
The article shows the lack of continuity and the relationship between the quality of medical care in the mandatory medical insurance system (MMI) and control of the quality and safety of medical activity. Named a number of problems in this regard in public health practice, one of which is the absence in most of the medical organizations of the country internal control systems of quality and safety of medical activity. Asked to create one for the whole health of the Russian Federation the Order of evaluation of the quality and safety of medical care, regardless of whether this examination in a medical organization that is involved in the implementation of insurance programmes, or it is performed in a medical organization, in which the implementation of the programs of the MMI is not involved.
2018 № 10 The experience of interregional Clinic and Diagnostic Centerin health care delivery within the mandatory medical insurance and charged services
An article discusses differences in the legal and regulatory framework in regulating the mandatory medical insurance and charged services. It is found out that conditions that lie at the root of the mandatory medical insurance system could be fully implemented using the causal approach to diagnostics and disease treatment. The causal approach within the mandatory medical insurance allows responding to the cause of the disease quickly and affordably. It is concluded that implementing mandatory medical insurance systems and charged services in a medical facility requires their different positioning, and in this case they will not repeat each other or compete with each other, but complement each other perfectly. The article describes the experience of Interregional Clinic and Diagnostic Center in organizing charged services using a system approach that allows forming an aggregate picture of a disease taking into account a plenty of factors and opinions from various experts. The conceptual differences in organizing the health care delivery in the mandatory medical insurance systems (causal approach) and charged services (system approach) within the activities of Interregional Clinic and Diagnostic Center allowed to define both systems as mutually supportive systems that fully meet the needs of people in medical services.
2015 № 2 On certain issues occurring in medical insurance organizations functioning in the mandatory medical insurance system
Modernization of mandatory medical insurance system should imply a broader usage of reserves from medical insurance organizations (MIO). These reserves are interlinked with changes in the legislation, regulating the responsibilities and obligations of insured citizens, commitment of MIO in covering expenses for medical aid, provided outside of the region, the order of utilizing assets of MIO.