Articles with tag: «volumes of medical care»

    Manager of heath care consults
  • 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.

    Authors: Kadyrov F. N. [95] Obukhova O. V. [18] Chililov A. M. [7]

    Tags: advance payment1 financial support1 mandatory medical insurance10 medical insurance organizations4 medical organizations15 payment for medical care4 volumes of medical care2

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  • Manager of healthcare consults
  • 2019 № 3 Рayment for medical care provided in excess of the volumes of granting of medical aid in system of obligatory medical insurance

    Сurrently, health organizations are extremely important are the issues associated with excess of volumes of granting of medical aid in system of obligatory medical insurance. This is the so-called problem of "super-planned patients". The current legislation does not provide for payment of super-planned volumes of medical care.. But the incidence rate is difficult to predict with a high level of accuracy. Within the framework of the current regulatory framework, all financial risks in this situation are assigned to the medical organization, which does not correspond to the logic of insurance. However, there are some options to mitigate this problem. This is illustrated by the court practice in this area.
    сompulsory medical insurance, volumes of medical care, insurance medical organizations, medical organizations, sanctions, the Commission on development of the territorial judicial practice.

    Authors: Kadyrov F. N. [95]

    Tags: insurance medical organizations3 medical organizations15 sanctions2 the commission on development of the territorial judicial practice1 volumes of medical care2 сompulsory medical insurance1

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