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For over a year, our initiative, in collaboration with the National Health Service of Ukraine (NHSU), has been working on the project "Enhancing the Transparency of the National Health Service of Ukraine's Activities in Monitoring Compliance with the Terms of Health Service Provision and Reimbursement Contracts."

With the support of the International Renaissance Foundation, together with the Kharkiv Expert Group for Health Reform Support, the ILF legal company, and the Health Solutions Foundation, we have started working on this project, which aims to improve the monitoring system and find optimal ways for cooperation between NHSU and service providers.

NHSU is a strategic purchaser responsible for paying for medical services for Ukrainians. Under the contract, every citizen can receive free medical services that are included in the medical guarantee program. Patients no longer need to pay for services that have already been paid for by the state, represented by NHSU.

NHSU, in turn, must ensure that service providers fulfill the terms of the contract. For this purpose, an updated monitoring system has been created, which is designed to ensure the effective use of funds collected from Ukrainian taxpayers and, on the other hand, guarantee the provision of free, accessible, and quality medical services through the uncompromising fulfillment of contract terms.

Key Advantages of the Updated Monitoring System

Two-Tier System

Representatives of interregional departments conduct documentary monitoring and monitoring visits, while the central office acts as an appeal body where service providers can present their explanations and objections regarding the prepared conclusions.

Planned and Unplanned Monitoring

Every six months, NHSU will form a plan based on the results of automated monitoring, which operates according to a risk-based approach. Unplanned monitoring will also be conducted based on risks identified during automated monitoring, minimizing the subjective factor. This is a significant achievement towards transparency and a corruption-free system.

Increased Role of Automated Monitoring

Data analysis in the electronic healthcare system is continuous, and service providers must understand the importance of accurate data entry into the Electronic Health System (EHR). This will improve the quality of information in the system and significantly reduce cases of abuse by individual doctors and providers.

NHSU Does Not Aim to Punish Providers

This is one of the main principles upon which the updated system is based. Therefore, the process includes a significant communication component, both with service providers and their owners. This is reflected in both the notification of all stages of monitoring and the procedure for addressing identified violations. If a service provider resolves the violations independently or as a result of implementing a corrective action plan, they will not incur penalties but only return the illegally received funds.

The System for Summarizing Monitoring Results Will Be Launched

Providers will be able to learn from specific examples of violations. Sanctions for identified violations are minimized and primarily aimed at their rectification, not punishment.