Summary. Large-scale transformations in the public health of
Russia relate to the reform of the financial system. The priorities of the
reforms are mainly translation of all the medical care insurance principles of
financing, implementation of payment of medical care for the full financial and
filled with fare implement ways of payment for medical care, performance
oriented health care organizations, the implementation of effective ways to pay
for health care workers, the search for new channels of financing the sector
through public-private partnerships.
Objective: to examine options for the formation of so-called
"full fare" for medical services rendered from the mandatory health
insurance. Each of the ways to include additional items of expenditure in the
fare has its advantages and disadvantages. Included in the rate of cost,
investment expenditure, also implies the need for an informed decision, taking
into account all the "pros" and "cons".
Methods: The study was accepted by the regulatory legal
documents a number of subjects, previously switched to pay for health care at
the full rate. We evaluated the technique to include additional items of
expenditure spent on health maintenance organizations that offer a way to
differentiate tariffs for the provision of medical care in relation to the
inclusion of costs in the tariffs for the purchase of medical equipment.
Results: The choice of method of payment for medical care at
the full rate of mandatory health insurance funds affected by factors, mainly
related to the financial security of regional programs of state guarantees free
medical care to citizens in the territories of each subject of the Russian
Federation. Another factor is the willingness of the health care system of the
Russian Federation to move to the most risky way of forming rate at which the
total dependence on the amount of the proceeds of medical care. The presented
results of the analysis of the advantages and disadvantages of each of the
possible methods of formation of the full tariff will help each subject to
choose the most appropriate option.
Keywords: full tariff, single-channel financing, compulsory
health insurance, the health care system
References
-
BulaevS. Question-and-answer.Byudzhetnye uchrezhdeniya zdravookhraneniya: bukhgalterskiy uchet i
nalogooblozhenie 2010;(11):44-47. (in Russian).
-
OnapprovingtheRulesofmandatory health
insurance: the Order of the Ministry
of Health and Social Development of the Russian Federationof 2011 February 28 N
158í.(ed.
2011 September 09). [Internet] 2011[cited 2013 Jan 21]. Availablefrom: http://base.consultant.ru/cons/cgi/online.cgi?req=doc;base=LAW;n=120516 (in
Russian).
-
On approving the reporting procedureand formsfor implementation of the regionalhealthcare
modernization programsin the RussianFederation subjects andthe programsof
modernization of the federalgovernment agencies providing health care: the Order of the Ministry
of Health and Social Development of the Russian Federationof 2010 December 30 N 1240í.[Internet]2010
[cited2013 Jan 21]; Availablefrom: http://base.consultant.ru/cons/cgi/online.cgi?req=doc;base=LAW;n=130871 (in
Russian).
-
On monitoring of transitionof the subjects of the RussianFederation to
predominantlysingle-channel financing
via mandatory health insurance: the Order of the Mandatory Health Insurance Fund of 2010
June 28 N 123. [Internet]2010. [cited 2013 Jan 21].Availablefrom:
http://base.consultant.ru/cons/cgi/online.cgi?req=doc;base=LAW;n=103240 (in
Russian).
-
Tariff agreement on payment for
medical care in the system of Mandatory Health Insurancein Kursk region for
2012. [Internet]2012[cited 2013 Jan 21].Availablefrom: http://kurskoms.ru/index/284--2012- (in
Russian).
-
TariffagreementonpaymentformedicalcareinthesystemofMandatoryHealthInsuranceinKalugaregionof
2011 December 28. [Internet]2011 [cited2013 Jan 21].Availablefrom: http://oms.kaluga.ru/docums/files/tarif_sogl_2012_4.doc (in
Russian).
-
Tariff agreement on payment for
medical care in the system of Mandatory Health Insurancein Kemerovo region for
2012. [Internet]2012 [cited2013 Jan 21].Availablefrom:http://site.kemoms.ru/default.aspx?id=13947 (in
Russian).
-
Tariff agreement on payment for
medical care in the system of Mandatory Health Insurance in Vologda region for
2012. [Internet]2012 [cited2013 Jan 21]. Availablefrom: http://new.oms35.ru/upload/Doc_2012/tar_soglash_na2012.PDF. (in
Russian).
-
Tariff agreement on payment for
medical care in the system of Mandatory Health Insurancein Kostroma region (ed.
2012 Jan 31). [Internet]2012 [cited2013 Jan 21].Availablefrom: http://tfomsko.ru/tarify/226-tarifnoe-soglashenie-ot-31012012 (in
Russian).
-
Tariff agreement on payment for
medical care in the system of Mandatory Health Insurance inRepublic of Mariy El
for 2012. [Internet]2012[cited2013 Jan 21].Available from: http://www.rfoms.mari-el.ru/tarifagr.html (in
Russian).
-
Tariff agreement on payment for
medical care in the system of Mandatory Health Insurance in Kirov region for
the 1st quarter 2012. [Internet]2012 [cited 2013 Jan 21]. Available from:
http://kotfoms.kirov.ru/?action=nd (in Russian).
-
On assessing the efficiency of
executive bodies in the subjects of the Russian Federation: the Decree of the
President of the Russian Federation of 2007 June 28 N 825. [Internet]2007 [cited
2013 Jan 21]. Available from: http://base.garant.ru/191419/ (in Russian).
-
On Mandatory Health Insurance in the
Russian Federation: the Federal Law of 2010 November 29 N 326-FZ (ed. 2011 Dec
03). [Internet]2011 [cited 2013 Jan 21]. Available from:
http://base.consultant.ru/cons/cgi/online.cgi?req=doc;base=LAW;n=138533 (in
Russian).
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