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| Health Financing Reform in Ukraine
FIGURE 3.3
E-Health development timeline E-Health introduced by CabMin Resolution # 411 of 25.04.2018
NHSU starts paying for PHC by capitation (July 2018)
2018
NHSU assumes administration of AMP (April 2019)
PMG-2020 begins in April 2020
2019
2020
The NHSU launches PHC financing reform and takes over the AMP: • E-Declarations for patient enrollment • E-Registers of PHC providers and personnel • E-Contracts with the NHSU • E-Prescriptions of medicines for the AMP
PMG-2021 begins in April 2021
2021
Support PMG-2020:
Further plans:
• Electronic health records • E-Referrals • Extended information on treatment of patients with COVID
• Online accounts for patients • Integration with the EMC e-system (“Central 103”) • Inpatient records (“diary”) • E-Prescriptions for all AMP medicines • Integration with public health systems • Integration with other government systems (State Register of Medicines, MoH License Register, Demographic Register, etc.)
Source: Original figure for this publication. Note: AMP = Affordable Medicines Program; EMC = emergency medical care; MoH = Ministry of Health; NHSU = National Health Service of Ukraine; PHC = primary health care.
registration with the PHC provider, paid by capitation, free of charge for the population, and no co-payments. Balance billing is not permitted. PHC providers may only charge patients for defined (chargeable) services listed in the Cabinet of Minister’s Decree 11382 in an amount approved by local authorities. There have been no major changes to the definition of the PHC benefits package, purchasing arrangements, and service delivery requirements, except for an upward adjustment of capitation rates in November 2020 to compensate for the risks of delivering care during the COVID-19 pandemic and some COVIDrelated protocols to ensure health care worker and patient safety. As with all services in the PMG, utilities are paid by subnational governments (SNGs), and the SNGs can also add supplementary financing if they wish.
Scope of PHC services covered by the PMG PHC services covered by the PMG are explicitly defined and provided to all residents of Ukraine enrolled with primary care physicians. These services include diagnostics and treatment of common and chronic conditions, preventive screening and vaccination, pregnancy, childcare, and certain types of emergency and palliative care. MoH Order 504 of 2018 defines the scope of PHC service, including 17 types of PHC consultations and interventions and 8 types of laboratory and diagnostic examinations as well as minimum requirements for staff and equipment. The AMP, which pays for prescribed medicines purchased at pharmacies, is designed around the PHC benefit package. The PHC benefit package was
