On Wednesday, March 6, U-LEAD experts Yevhen Meshko and Anna Lishchyshyna held an info session for representatives of the municipalities on “2024 Features of the Medical Guarantee Programme: Implementation and Monitoring”.
It covered this year’s changes to the Medical Guarantee Programme (MGP) and how they can be used for more effective management of a healthcare facility. The experts also clarified the monitoring mechanism of the National Health Service, stressing that the main purpose of this activity was to correct errors made by healthcare facilities, improve the quality of services and use funds more effectively.
This year, the Medical Guarantee Programme includes 44 packages, including three new ones: infertility treatment, transplantation treatment for adults and children, stem cell transplantation treatment for adults and children.
Changes in the Primary Medical Care package
The coefficient for the provision of services to patients aged 6 to 18 decreased, and the coefficients in two age groups, 40 to 65 and 65+, increased
What does it mean? For paediatricians, the monthly or annual budget per district will be cut, and for therapists, it will be expanded. Family doctors will face a cross-change in the age coefficients for children and adults. The average income of family doctors will see almost no changes.
More declarations ≠ more income
What does it mean? There is no need to declare more than the prescribed limit, because it will not bring any income. If the doctor has more than 150% of declarations, the National Health Service pays UAH 0 for all declarations over the limit. A reduction factor (from 100% to 150%) is applied for each subsequent 10% of over-limit declarations.
Why? Any over-the-limit declarations affect the quality of medical services. As the number of patients at a family doctor increases, the quality of medical care— prescriptions, referrals, filling out registration forms, treatment of diseases — deteriorates.
What should you do? Seek available family doctors and motivate patients to sign declarations with them.
Patient declarations must be verified by October 1
What does it mean? The National Health Service will not pay for declarations that have the “unverified” status or that require data clarification.
What should you do? Complete verification of patients by October 1. The declaration must have the status “Successfully verified”. Patient contact information and identification code must be specified. These are the indicators checked by the electronic monitoring of the National Health Service. Should there be any doubts or incomplete fields, the declaration will not be verified.
From April 1, regional hospitals stop providing primary healthcare services.
What does it mean? These institutions will not be able to declare patients. And those declarations that were concluded will be terminated.
What should you do? These are additional opportunities for the facilities located close to regional institutions. Moreover, there are many patients from the regions who concluded declarations with regional facilities, especially those who are treated there and need specialised support (cancer, tuberculosis patients, etc.). These patients will now be without declarations.
From July 1, the National Health Service expands the list of medicines under the Affordable Medicines Programme.
What does it mean? Medicines for patients with mental and behavioural disorders and epilepsy will be paid for by the National Health Service of Ukraine. Whereas now these medicines are purchased at the expense of local budgets.
New packages: transplantation and artificial insemination
Transplantation: in Ukraine, transplantation is offered in facilities of the network of transplant centres that have an agreement with the National Health Service for this package. And National Health Service is the entity that pays for the service.
Local budgets allocate money to support patients with kidney failure, heart, lung and other serious diseases. According to experts, transplantation will improve the patient’s quality of life and allow for reducing the burden on the local budget.
Doctors should inform patients who need a transplant about the possibility of receiving this service.
Artificial insemination has always been an expensive but unreliable service. The state has now taken over these expenses, which offers great opportunities for married couples. Patients should be informed about this option. The National Health Service dashboards have information about facilities that have signed a contract with the National Health Service to provide this service.
The expert also spoke about changes in the packages related to emergency medical care, palliative care, haemodialysis, perinatal care, neonatal screening, surgical packages, etc.
As a separate section, the experts pointed out recommendations for local self-government bodies regarding the support and development of healthcare facilities in the municipality:
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Help ensure compliance of the building or premises with accessibility requirements, compliance of the physical infrastructure with the requirements of the Primarily Healthcare package. Make sure you do this as quickly as possible, since the National Health Service has already started monitoring medical service providers under the Medical Guarantee Programme.
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Consider strategic priorities and opportunities for the municipality’s residents and healthcare providers, given the municipality’s capabilities and needs, taking into account changes and innovations of the Medical Guarantee Programme, as well as the National Strategy for the Healthcare System Development. Strategies should be based on the actual needs of the municipality’s residents. There is no need to open a heart surgery centre in a hospital that will not have a sufficient workload, instead of having, say, a mental health centre, which will definitely have a workload and will be useful to the population. When doing the calculations, keep in mind the actual needs and priorities of your population or the residents of the municipalities served by your health centre.
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Look for additional motivational incentives in the case of a shortage of human resources to increase the attractiveness of working conditions in the municipality at the primary healthcare level.
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Support the improvement of the efficiency of financial activities.