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Tuesday, September 25th, 2018

New model of guaranteed free medical services to be introduced in Kazakhstan in 2018

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The Ministry of Healthcare of the Republic of Kazakhstan, within the framework of executing the order of the Head of State of 10.01.2018, suggests considering new approaches to the formation of the GVFMC and the medical care package within the compulsory social medical insurance system (CSMI).

The volume of financing of GVFMC, placed by the Fund of Social Health Insurance this year is 923.8 billion tenge, including for the purchase of medical services – 776.9 billion tenge.

Along with this, new providers of medical services have appeared. For example, with the relatively same amounts of financing of GVFMC, there was an increase in the number of providers of medical services, the number of which in the first quarter of this year amounted to 1390, which is 349 (or 33.5%) more than last year (1041), � Minister of Healthcare Yelzhan Birtanov said during the government meeting on May 29, 2018.

He also added that the implementation of this GVFMC model is supposed to be implemented in 3 stages. First of all, under the existing conditions, a full audit of medical care in the GVFMC package will be carried out in order to fully detail and optimize the GVFMC by prioritizing and limiting the non-priority medical services. Second stage: the deployment of a new GVFMC model simultaneously with the introduction of CSMI. This stage will be characterized, on the one hand, by the definition of clear boundaries of the state’s obligations under the GVFMC and further ensuring the policy aimed at the prevention and priority development of primary health care, on the other, a full-scale transition to the CSMI system and its further development. And thirdly, the regular updating of the lists of GVFMC and CSMI, taking into account the development of medical technologies.

With regard to the improvement of GVFMC, the following is proposed:

– Reduction of the number of diseases subject to dynamic monitoring (optimization of diseases from 254 to 25, with increasing access to PHC with regards to diseases causing demographic damage, reducing the burden on PHC medical workers).

– Elimination of obsolete / inefficient diagnostic methods (elimination of 16 consultations of specialized doctors, more than 900 KDU, limiting the consumption of diagnostic and laboratory services).

– Redistribution of the patient flow to a more economical level of hospital-replacement care (priority treatment of diseases at the level of hospital-replacement care (769/529 diagnoses, surgeries and manipulations).

If the proposed approaches are approved, a step-by-step implementation of the new GVFMC model will be carried out alongside additional work to adjust the 3-year budget, including in terms of the state’s spending on health, � Yelzhan Birtanov summed up his speech.

For reference: With the CSMI system, medical assistance will be aimed at improving the quality of life of every person: expensive laboratory and diagnostic services; out-patient drug support for diseases not covered by GVFMC; access to hospital-replacement care; planned inpatient care, except for GVFMC; rehabilitation treatment and medical rehabilitation.

Source: Government of the Republic of Kazakhstan

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