During her working visit to Almaty, Health Minister Akmaral Alnazarova visited the city's medical facilities and held a meeting with the medical community. During the meeting, problematic issues in the area of maternal and child health were discussed, where it is necessary to strengthen work on pre-pregnancy training, ensure interaction with primary health care organizations and specialized scientific centers.
Summing up the work of the healthcare system in 2024, she specifically focused on reforms in the compulsory medical insurance (CMI) system, revision of the regulatory framework and development of more than 240 amendments to the Code "On Public Health and the Healthcare System". These measures are aimed at improving the CMI system, forming a single package of state medical care and increasing its transparency.
"In his Address to the People of Kazakhstan in September of this year, the Head of State instructed to form a Single Package of Medical Assistance (SPMA), which will be balanced with the budget's capabilities. Everything that goes beyond this package should be covered through the health insurance system. In order to move to single-package financing, we have carried out a lot of analytical work and made calculations," the Minister noted.
The Ministry of Health has developed a mechanism for a phased transition to a Unified Package, which envisages the inclusion of primary health care (PHC) services in the compulsory medical insurance package by 2027.
At the same time, free state guarantees (GGBMP) for all citizens, regardless of their insurance status in the compulsory medical insurance system, will be retained for the following types of medical care:
- Emergency care;
- Diagnostics and treatment of all infectious diseases;
- Diagnostics, treatment, drug provision, inpatient and inpatient-replacing care for socially significant diseases that cause the greatest harm to the health of citizens (tuberculosis, mental, behavioral disorders, HIV, oncology, chronic hepatitis and cirrhosis of the liver, orphan diseases, acute myocardial infarction, strokes);
- Emergency inpatient care for life-threatening conditions;
- Palliative care;
- Provision of blood products.
The Minister emphasized that the introduction of the Unified Package of Medical Care will lead to a number of positive changes. This includes clear boundaries between the State Fund for Free Medical Care and the Compulsory Medical Insurance, without duplication of services, access to examinations for suspected socially significant diseases and cancer screening regardless of the status in the Compulsory Medical Insurance, and an increase in tariffs in accordance with real costs.
It is planned that in 2027, work will be completed on the transition to a predominantly insurance financing model, where the ratio of expenses will be 30% for the guaranteed volume of medical care (1.2 trillion tenge) and 70% for the compulsory medical insurance (2.85 trillion tenge).
It is important to note that today the state pays insurance premiums for 15 categories of the population, including children, pregnant women, pensioners, students, people with disabilities, the unemployed and other categories of the population, which make up over 11.9 million Kazakhstanis. They are provided with access to medical care regardless of their insurance status.
As a result of the inclusion of all categories of citizens in the compulsory medical insurance system, including 1.1 million residents with a crisis level of well-being, the level of insurance in the group of people with socially significant diseases will increase to 93%.
In general, the measures taken to increase the coverage of the population with health insurance, the state's obligations to insure the privileged category of the population minimize the risks of inaccessibility of medical care, including the provision of primary health care.
The head of the department also spoke in more detail about the modernization of primary health care and positive changes for patients in terms of accessibility and quality of medical care.
Источник: Казахстанский Фармацевтический Вестник, pharmnews.kz
Summing up the work of the healthcare system in 2024, she specifically focused on reforms in the compulsory medical insurance (CMI) system, revision of the regulatory framework and development of more than 240 amendments to the Code "On Public Health and the Healthcare System". These measures are aimed at improving the CMI system, forming a single package of state medical care and increasing its transparency.
"In his Address to the People of Kazakhstan in September of this year, the Head of State instructed to form a Single Package of Medical Assistance (SPMA), which will be balanced with the budget's capabilities. Everything that goes beyond this package should be covered through the health insurance system. In order to move to single-package financing, we have carried out a lot of analytical work and made calculations," the Minister noted.
The Ministry of Health has developed a mechanism for a phased transition to a Unified Package, which envisages the inclusion of primary health care (PHC) services in the compulsory medical insurance package by 2027.
At the same time, free state guarantees (GGBMP) for all citizens, regardless of their insurance status in the compulsory medical insurance system, will be retained for the following types of medical care:
- Emergency care;
- Diagnostics and treatment of all infectious diseases;
- Diagnostics, treatment, drug provision, inpatient and inpatient-replacing care for socially significant diseases that cause the greatest harm to the health of citizens (tuberculosis, mental, behavioral disorders, HIV, oncology, chronic hepatitis and cirrhosis of the liver, orphan diseases, acute myocardial infarction, strokes);
- Emergency inpatient care for life-threatening conditions;
- Palliative care;
- Provision of blood products.
The Minister emphasized that the introduction of the Unified Package of Medical Care will lead to a number of positive changes. This includes clear boundaries between the State Fund for Free Medical Care and the Compulsory Medical Insurance, without duplication of services, access to examinations for suspected socially significant diseases and cancer screening regardless of the status in the Compulsory Medical Insurance, and an increase in tariffs in accordance with real costs.
It is planned that in 2027, work will be completed on the transition to a predominantly insurance financing model, where the ratio of expenses will be 30% for the guaranteed volume of medical care (1.2 trillion tenge) and 70% for the compulsory medical insurance (2.85 trillion tenge).
It is important to note that today the state pays insurance premiums for 15 categories of the population, including children, pregnant women, pensioners, students, people with disabilities, the unemployed and other categories of the population, which make up over 11.9 million Kazakhstanis. They are provided with access to medical care regardless of their insurance status.
As a result of the inclusion of all categories of citizens in the compulsory medical insurance system, including 1.1 million residents with a crisis level of well-being, the level of insurance in the group of people with socially significant diseases will increase to 93%.
In general, the measures taken to increase the coverage of the population with health insurance, the state's obligations to insure the privileged category of the population minimize the risks of inaccessibility of medical care, including the provision of primary health care.
The head of the department also spoke in more detail about the modernization of primary health care and positive changes for patients in terms of accessibility and quality of medical care.
Источник: Казахстанский Фармацевтический Вестник, pharmnews.kz