Health Insurance Fund. Results of work
The results of the work of the Medical Insurance Fund for 10 months were announced at a meeting of the Public Council of the Ministry of Health of the Republic of Kazakhstan.
Today, at the V meeting of the Public Council of the Ministry of Health of the Republic of Kazakhstan, the results of the work of the Social Health Insurance Fund for 10 months of this year were announced.
In the report to the members of the Public Council of the department, Bolat Tokezhanov, Chairman of the Board of FSMI NJSC, noted that this year about 2 trillion tenge is provided for the provision of medical services to the population, including 1.3 trillion tenge for guaranteed medical care, and 700 billion tenge for compulsory medical insurance. … As of November 8, 2021, 1.5 trillion tenge was accepted for payment for the provided medical services under the guaranteed volume of medical care and compulsory medical insurance. In connection with a significant increase in funding for health care, there is an increase in the availability of medical care within the framework of the compulsory health insurance. The number of consultations and diagnostic services at the polyclinic level increased by 33%. In general, consultative and diagnostic assistance was provided in the amount of 124 billion tenge. More than 620 thousand patients were treated according to the compulsory health insurance system in a planned manner in hospitals, 558 thousand operations were performed. The number of patients awaiting planned hospitalization for 10 days or more decreased by 13% (from 21 thousand in 2020 to 18 thousand patients this year). The cost of the provided inpatient medical care amounted to more than 262 billion tenge, and inpatient and inpatient care for the rural population – more than 90 billion tenge. Given the role of the Foundation as a defender of the patient’s rights, the number of complaints from citizens through all feedback channels is growing. In 2021, their number increased to 732 thousand and already exceeded the indicators of 2020 by more than 40%. At the same time, out of the total flow of complaints, the number of complaints amounted to more than 13 thousand. According to the results of the report, it was noted the need to increase the role of Patient Support Services in the medical organizations themselves, responsible for establishing communications between the medical organization and patients. Also, members of the OS drew attention to the issues of involving the population in the compulsory health insurance system, pointing out the need to intensify the work of local executive bodies and the State Revenue Committee. Talking about the plans of the Fund for 2022, Bolat Tokezhanov noted the envisaged revision of tariffs taking into account the costs of the annual increase in the salaries of medical workers.
In addition, within the framework of the implementation of the “Healthy Nation” National Project , the following steps are expected to improve the availability of medical care:
– increasing the coverage of rural settlements with primary health care and consultative and diagnostic assistance, including the services of mobile mobile complexes in remote settlements;
– increasing the availability of expensive medical services;
– providing pregnant women with individual and interdisciplinary antenatal care, as well as ensuring the availability of IVF for medical reasons;
– coverage of children under 1 year of age with proactive observation and screenings;
– coverage of medical rehabilitation for children with disabilities.
The members of the Public Council voiced questions and recommendations on improving the mechanism for considering appeals and complaints from the population, revising tariffs for a number of medical services, the need to support scientific activities of research institutes, stimulating the development of telemedicine, etc.
Nadezhda Petukhova, the chairman of the Public Council, noted that despite the fact that the introduction of compulsory health insurance coincided with the pandemic, funding for medical organizations has significantly increased. She urged the medical community at meetings with the public to speak more actively about health insurance and the benefits of the system. Based on the results of consideration by the members of the Public Council, the report of the Chairman of the Management Board was adopted and a positive assessment of the activities of the Fund was given. In addition, the members of the OC heard a report on the observance of the Code of Ethics in the Ministry of Health, as well as on measures to prevent corruption.
For reference: In the form of contributions and deductions for compulsory health insurance for 10 months of 2021, 620.4 billion tenge was received. Of these, government contributions for beneficiaries amounted to 48% of all receipts or 297 billion tenge.
Thus, the state continues to maintain its social obligations to the population. Employers’ contributions for their employees in total left 156 billion tenge (25.2%), employee contributions – 141 billion tenge (22.8%). To date, the number of providers providing medical care under direct contracts with the Fund is 1,393 healthcare entities, of which 686 (49%) are state-owned and 707 (51%) are private.