The Presidium of the Supreme Medical Council has negatively assessed the draft order of the President of the National Health Fund regarding changes to the rules for implementing contracts in outpatient specialized care (AOS). According to physicians, the proposed mechanism for motivating providers is in fact a form of punishment and may lead to financial destabilization of facilities.
Supreme Medical Council critical of NFZ project: it's a punishment, not a bonus
Published Sept. 30, 2025 07:57
Fot. Thinkstock / Getty Images
While PNRL appreciates the very idea of raising the proportion of specialty services provided to new patients and realizing comprehensive patient care. However, the proposed method of incentivization is questionable. This is because the NFZ has provided for a reduction in the funding ratio (to 0.75) for providers who fail to achieve the set values.
- It would be reasonable to reward those who achieve a high level of benefit realization, rather than penalize the others by lowering the rate," the post emphasized.
The local government points out that the new conditions imposed during the execution of contracts may seriously hamper the planning of AOS facilities' activities, and consequently worsen their liquidity. Doctors also criticize the mechanical reference to the nationwide median of services, which does not reflect the diversity of patients' needs in different regions.
In the opinion of the Presidium of the NRL, the proposed mechanism is, in practice, a cost-cutting tool for the NFZ, rather than a real support for the quality of care. Moreover, it may lead to a situation in which providers, fearing sanctions, will provide services to patients without clear medical indications, just to achieve the required indicators.
The medical self-government once again stressed that an effective way to improve the quality of services in AOS is a system of rewarding realized services with a positive coefficient, rather than mechanisms based on financial sanctions.
Source: NIL
