References

Ukraine. The NHSU is responsible for fine-tuning and developing the UDRG grouping algorithm. Each clinical group / UDRG is assigned a payment rate and cost-weight. 31. The resolution was issued by the Cabinet of Ministers through Resolution #610 of 19.06.2020. Full text is available at https://zakon.rada.gov.ua/laws/show /610-2020-%D0%BF#Text.

REFERENCES

Ministry of Health of Ukraine. 2019. Як застосовувати телемедицину лікарям первинної ланки: методичні рекомендації [How primary care physicians should apply telemedicine: guidelines].

August 22. https://moz.gov.ua/article/for-medical-staff/jak-zastosovuvati-telemedicinu -likarjam-pervinnoi-lanki-metodichni-rekomendacii. Ministry of Health of Ukraine. n.d. “Concept of Primary Health Care Development in Ukraine to 2031.” Unpublished manuscript. NHSU (National Health Service of Ukraine). 2020. NHSU Guidebook: PMG Packages—Approach to Contracting Medical Facilities. February 7. https://nszu.gov.ua/storage/editor/files /paketi-medichnikh-poslug-07022020_1581100466.pdf. WHO (World Health Organization) and Ministry of Health of Ukraine. 2020. “White Paper on

Health Service Delivery in Ukraine.” Unpublished manuscript.

4

Governance of the Program of Medical Guarantees

The creation of a health service–purchasing agency, such as the National Health Service of Ukraine (NHSU), along with the introduction into the health system of the strategic purchasing function, necessitates changes in governance structures. The key functions of these governance structures should be to set the strategic direction for the purchasing agency and to hold it accountable for resource use and results.

Five aspects of governance are essential to enable this. These are: • Autonomy of the purchasing agency with respect to technical and operational matters, subject to government authority on policy and setting strategic objectives. • Clarity and transparency in roles for government bodies involved in policy and oversight of the NHSU—notably, the Cabinet of Ministries (CabMin), the Ministry of Health (MoH), and the Ministry of Finance (MoF)—together with explicit, transparent methodologies, rules, and processes for decision-making. • External accountability and effective oversight, with clear lines of accountability and citizen participation. • Effective systems of internal control and risk management within a firm and credible budget constraints. • Well-coordinated and constructive interagency relationships between the purchaser and the ministries responsible for health and finance policies as well as with the subnational (local) governments (SNGs) responsible for health facilities, which in Ukraine are also involved in co-financing health care. In addition, adequate capacity of all agencies involved in governance arrangements in terms of personnel and other resources is a prerequisite not only for effective performance but also to underpin meaningful reporting on performance, review, and evaluation. Strengthening the quality and availability of NHSU data, as well as its capacity for data analysis, is another important aspect that will provide information of value to the MoH in exercising its stewardship over the sector and ensuring good governance of providers.