The IEP Suggests a New Methodology for Remunerating Medical Organizations

On 5 December 2012, Head of the Budget Federalism Department of the Gaidar Institute Vladimir Nazarov took part in the meeting of the Methodological Council for Coordination and Experts' Support of Research Organization and Specialist Training for the Compulsory Medical Insurance (CMI) System under the Federal Compulsory Medical Insurance Fund.


Vladimir Nazarov delivered a report on a completed study on the theme ‘Development of the Methodology for Remunerating Medical Organizations at the Expense of the Statutory Insurance Reserves of the Territorial Compulsory Medical Insurance Funds, As a Factor Responsible for Improving the Level of Quality and Accessibility of Medical Care’.

Within the study’s framework, one of the components of the remuneration system for CMI participants was considered, namely the remuneration of medical organizations at the expense of the statutory insurance reserves of the territorial compulsory medical insurance funds. The possibility to obtain this type of remuneration is granted to all medical organizations implementing the territorial government guarantees program, irrespective of their form of ownership or organizational-legal form. The organizations – remuneration recipients are to be determined by applying a rating system based on an integrated estimation of their performance.

For the computation of estimates, a number of sets of target indices are suggested for medical organizations operating in a specific field. Each set of target indices includes some basic medical care quality and accessibility indices, as well as defect indices that can rule out entirely or substantially reduce the potential remuneration size.

Besides, a methodology was suggested for computing the integrated estimation and remuneration to the relevant organizations, based on their achieved performance level and the rate of development of their target indices, as well as the existing defects in the provision of medical care. As a result of applying that methodology, it will become possible to create appropriate financial incentives for the organizations with high performance levels, as well as for those with high rates of development.