CHI-costing: the Federal mandatory medical insurance Fund told how to spend your three-year budget

Tariffs for payment of medical services will be put in order, cancer patients will provide treatment in full, the salaries of health workers will continue to rise, and staff shortages in primary care will be eliminated. Federal Fund of mandatory medical insurance promises to solve the most pressing problems of the industry by 2021.

The state Duma approved the budget of the Federal compulsory medical insurance Fund in 2019 and the planning period of 2020 and 2021 years. Costs FFOMS next year составят2,19 trillion, in 2020 is 2.35 trillion in 2021 2.5 trillion rubles.

These costs are incorporated, including funds for the elimination of personnel shortage due to 204-m decree of the President of the Russian Federation, informed the deputies of the head of the Fund Natalia stadchenko. According to her the increase in the number of doctors and nurses in the budget: in 2019 12.3 billion rubles in 2020 34.7 billion rubles, in 2021 50.4 billion rubles. By these means in 2019 it is planned to employ 5.4 million primary care doctors, and by 2021 their number is expected to increase by 21.4 thousand. The number of nurses will increase by 11.9 thousand, respectively, and 40.2 thousand people.

Thus, in Fomsa made sure that the money allocated for the elimination of skills shortages, is not flowed through the system, said Stadchenko. For this purpose, the Law On mandatory medical insurance was amended to include the target redundancy in territorial funds OMS of grants allocated for these purposes. It is expected that medical facilities will be provided monthly to the territorial Fund applications for payments to employees hired. The grants also included funds needed to maintain the ratio of salaries of doctors at the level of 200% and average medical staff – 100% to the average income in the region.

The average per capita ratio within the system is set to 11.8 thousand rubles. Thus, in each region are established by coefficients depending on local conditions. For example, in Yakutia, the figure is 34.5 thousand rubles. It is planned to increase high-tech medical care not included in base program OMS. In 2019, spending on these purposes is planned in the amount of 100,8 billion rubles in 2020 of 103.9 billion rubles, 2021 109,0 billion. From 2020 it is planned to include in the list of high-tech medical care proton therapy and provide assurance 5 billion.

The financing of medical care for cancer patients at the MHI will increase by 72% andwill be adjusted in accordance with clinical guidelines and treatment protocols, promised Stadchenko. If the average cost of inpatient hospitalization is about 30 thousand rubles, for oncopatients the average tariff will rise to 76 thousand rubles. The cost of industry in 2019 will amount to 70 billion rubles in 2020 115 billion in 2021 134,5 billion. This will allow in 2019 to eliminate the shortage of chemotherapy drugs, and by 2020 radiotherapy and surgical care.

Plan and troubleshoot problem areas in Oncology. Such as lack of beds in day hospitals for chemotherapy, the rejection of targeted drugs in favor of cheaper but less effective drugs, failure to follow clinical guidelines, failure to assign the prevention of complications after chemotherapy. Changing approaches to prevention. If still the citizens of Russia had the right to free medical examination every three years , starting next year they will be able to undergo an annual routine inspection.

In addition, next year the Federal Fund is entrusted control over the tariff agreements of constituent entities of the Russian Federation. According to the head of the Fund, at the beginning of 2018, only 18 of the 85 regions of Russia were able to provide tariff agreements that meet Federal regulatory framework (not underestimated for some medical organizations and not inflated for others).

Irina Reznik