Payment methods for primary health care, specialized (including high-tech) medical care in the compulsory health insurance system: the logic of the most urgent changes in the tariff policy of 2023.

Abstract

The article discusses new methodological approaches to the methods of paying for medical care in the compulsory medical insurance system for 2023, including those approved by recently issued regulatory legal acts, as well as joint recommendations of the Ministry of Health of Russia and the Federal Compulsory Medical Insurance Fund (FOMS). The article analyzes the main reasons for changes in the tariff policy and their expected consequences in terms of increasing the motivation of medical organizations. It is noted that there is a need to revise the remuneration systems of employees of medical organizations (primarily state and municipal) in order to more closely link incentive payments with performance indicators used in determining the amount of payment for medical care, which is intended to become an important motivation tool for improving the availability and quality of primary health care and, as a consequence, reducing the need for specialized medical care. An overview of innovations in the payment of high-tech medical care is given.