Among the most significant reasons for the change in the regulatory legal framework of compulsory health insurance (CHI) should be recognized the emergence of new opportunities in the field of information processing, capable on the one hand to significantly increase the convenience and accessibility of medical care for citizens, on the other – to ensure transparency and efficiency of spending of the budget system of the Russ ian Federation, control over this by the state. Being at the intersection of healthcare and finance, CHI with the advent of new technologies has received a unique chance to radically simplify and optimize the procedures for financing healthcare, allow medical professionals to focus on providing medical care, minimize their participation in bureaucratic procedures.
Changes in the approach to information processing in the compulsory health insurance system not only ensure the optimal use of public funds to improve the health and quality of life of citizens, but also stimulate changes in the processes themselves in the healthcare sector, providing new opportunities for the state, doctors and patients, rethinking the functions of participants in the compulsory health insurance system.

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.

Reducing mortality from major chronic non-communicable diseases is a priority direction for the development of the healthcare system. At the state level, the task has been set to combat oncological diseases as one of the main causes of mortality of the population. Rational and sufficient financial provision of oncological care at the expense of mandatory medical insurance largely determines the use of modern medicines, effective treatment regimens and compliance with the established deadlines for providing medical care to patients.
The purpose of the work is to this study analyzes the volume and quality of cancer care and its financing in the Chelyabinsk region on the basis of information from the regional foundation of obligatory medical insurance.
Materials and methods: personalized accounting of insured persons, analytical reports, tables, databases, financial and methodological documents in the field of obligatory medical insurance. In the course of the research, the following scientific methods were used: system analysis, comparing, generalization.
The results of the study show that the modernization of the approach to financial provision of oncological care in the Chelyabinsk region has increased its availability and quality for the population. The development of medical science in the field of oncology follows the path of targeting therapy, which makes it possible to successfully treat patients for whom standard treatment methods are ineffective, and allows finding ways to correct the identified pathology.
Сonclusion: the development of the pharmaceutical market leads to the emergence of new, often expensive, medicines. In this regard, we can only expect a further increase in the need for chemotherapeutic drugs and, as a result, an increase in costs. In this regard, the improvement of the drug supply system, including obligatory medical insurance, is one of the priority areas in ensuring the availability and quality of medical care.

Nowadays, creation of a new medical organization model providing primary healthcare services (New Model) is broadly associated with the introduction of lean manufacturing technologies. In the setting of modern healthcare development, the challenge of evaluating the efficiency of the medical organization activities remains primary and unresolved, especially in the context of introduction of new methodological approaches. The article describes the experience of creating and evaluating the efficiency of the New Model implementation in medical organizations of the Sverdlovsk region operating in the compulsory medical insurance system.
The purpose of the study. To present the results of evaluating the effectiveness of the implementation of the New Model in medical organizations in the Sverdlovsk region.
Research materials. The activities of 79 medical organizations involved in the New Model creation and expansion in the period between 2017 and 2019 were analyzed.
Research results. The rate of staff involvement in the medical organizations was examined using an express “Questionnaire Q12” method; herewith 1,489 employees were interviewed in 2018, and 3,640 employees in 2019. The level of patient satisfaction with the medical care quality and availability, the number and amounts of fines/deductions/withdrawals for the outpatient care services collected by insurance medical organizations (IMOs), Territorial Fund of Compulsory Medical Insurance of the Sverdlovsk Region (TFCMI SR) were studied.
Conclusion. The New Model implementation increases the level of patient satisfaction with the medical care quality and availability, the number of fines/deductions for the outpatient care services collected by IMOs, TFCMI SR has been decreased. A high staff involvement in the medical organization activities has been observed, however certain activities aimed at satisfying the HR needs and staff motivation need to be developed. It is necessary to continue further evaluation of the efficiency of the New Model implementation in terms of medical, social and economic indicators. Crucial in the New Model implementation is the interaction between TFCMI SR, IMOs, and medical organizations in the provision of primary healthcare services aimed at the assessment of the medical care availability and quality, including patient satisfaction.

Forming a key source of the regulatory framework for the provision of medical care to the population since 2022, Russian National Guidelines have given rise to a complex set of legal relations in the financial and economic activities of medical organizations and constituent entities of the Russian Federation, associated with ensuring the necessary amount of medical care. This article analyzes the scope of opportunities for a regional health authority in providing the most effective system for financing oncological care in the region and analyzes examples of effective adaptation of the regional financing system to the requirements of clinical guidelines.