The first results of changes in the financing of federal centers in the system of compulsory health insurance on the example of the Bakulev National Medical Research Center for Cardiovascular Surgery

Until 2021, there were problems with the ability of citizens to receive medical care in organizations subordinate to federal authorities, especially those located in Moscow. Since 2021, the federal centers have been funded by the Federal Compulsory Health Insurance Fund (CHI).
Goal. To study the impact of the new system of payment for specialized medical care under the CHI program on its volume in the A. N. Bakulev NMICSSH.
Results. Number of outpatient consultations in the first half of 2021 has almost reached the level of 2019, despite the pandemic of a new coronavirus infection. The number of patients hospitalized for receiving high-tech medical care under the CHI program exceeded the indicator of 2019, for residents of the subjects of the Russian Federation, except Moscow, – for all types of specialized care.
Discussion. In the regions, measures were taken to limit the referral of patients to medical institutions that are not subordinate to the region. The possibilities of federal clinics were not fully used, citizens were limited in the possibility of receiving timely highly qualified medical care, waiting for it in regional institutions. In the worst situation were federal medical organizations located in Moscow, where payment was carried out at the tariffs of Moscow, which are significantly higher than in the absolute majority of other subjects of the Russian Federation. In this connection, the regions faced the question of paying for medical care for 10 patients in “their” medical organizations or 6–7 patients in federal clinics in Moscow.
Conclusion. The transition to the new system of payment for medical care in federal clinics directly from the Federal CHI Fund has significantly improved the implementation of citizens ‘ rights to choose a medical organization, reduced the waiting time for specialized, including high-tech, medical care, increased the efficiency of using the capabilities of federal centers both in terms of the use of modern technologies and personnel potential.

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