A socially oriented non-financial development institution and a major organizer of international conventions; exhibitions; and sporting, public, and cultural events.

The Roscongress Foundation – a socially oriented non-financial development institution and a major organizer of international conventions; exhibitions; and sporting, public, and cultural events.

The Foundation was established in 2007 with the aim of facilitating the development of Russia’s economic potential, promoting its national interests, and strengthening the country’s image. One of the roles of the Foundation is to comprehensively evaluate, analyse, and cover issues on the Russian and global economic agendas. It also offers administrative services, provides promotional support for business projects and attracting investment, and helps foster social entrepreneurship and charitable initiatives.

Each year, the Foundation’s events draw participants from 208 countries and territories, with more than 15,000 media representatives working on-site at Roscongress’ various venues. The Foundation benefits from analytical and professional expertise provided by 2,500 people working in Russia and abroad. In addition, it works in close cooperation with 122 economic partners; industrialists’ and entrepreneurs’ unions; and financial, trade, and business associations from 69 countries worldwide.

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The Role of Health Insurance Organizations in Delivering Obligatory Health Insurance Systems
6 June 2019
16:45—18:00
KEY CONCLUSIONS
Russia’s compulsory health insurance system is gradually developing

It is often said that the system is underfunded, but funding for the obligatory health insurance system has doubled over the past nine years. <...> Some say it is enough, some say it is not. Nevertheless, we are gradually moving forward in terms of filling the system up — Tatyana Golikova, Deputy Prime Minister of the Russian Federation.

The role of medical insurance companies is huge, <...> we have raised the requirements for them, <...> the medical insurance organizations that remain on the market – they understand that too. They have now established themselves, they are highly reputable, they have their own resources, and they offer us very interesting projects that we are going to implement together as part of our national projects — Natalya Khorova, Deputy Minister of Healthcare of the Russian Federation .

Improving the quality of healthcare is a national priority

The innovations that we introduced in 2011 required a completely different role and a different approach to patients. We switched to a patient-oriented system — Natalya Khorova, Deputy Minister of Healthcare of the Russian Federation .

The implementation of the national project in healthcare began on 1 January 2019. For the next 6 years, the Government allocates nearly 590 billion roubles to create infrastructure in the regions and 750 billion roubles to provide medical care for oncological patients — Evelina Zakamskaya, Editor-in-Chief, Doctor Channel; Anchor, Russia 24.

ISSUES
Shortcomings in healthcare funding

When establishing the scope of care in the obligatory health insurance system, preference is given to large medical organizations with able-bodied people. And, unfortunately, the is not much money for those that are located in remote areas <...> Today there is a 51 billion rouble deficit in the regional segment <...> when signing an agreement with the Ministry of Finance, the regions undertake to fulfill the scope of medical care. And to redeem the government guarantees programme. But they do not redeem the government guarantees programme — Tatyana Golikova, Deputy Prime Minister of the Russian Federation.

Complexity of combining social and voluntary insurance

It is impossible to take certain elements of social security system and combine them with the elements of commercial insurance <...> In social security, insurance comes at a uniform rate of the payroll — Yury Voronin, Chief Financial Commissioner for Consumer Rights, Financial Ombudsman Administration.

We cannot go on increasing the burden on entrepreneurs anymore, so some sort of combination model is inevitable — Igor Yurgens, President, All-Russian Insurance Association .

SOLUTIONS
Improving the insurance companies’ personal work with patients

Insurance companies must not only inform the insured that they can undergo medical exams, but also monitor this process. <...> Insurance representatives <...> must monitor the so-called specialized hospital admissions, and make sure that patients are in fact admitted to hospitals where they can and should be provided with the care they need — Tatyana Golikova, Deputy Prime Minister of the Russian Federation.

The main priority for us is the truly personal work with the insured and direct dialogue with the patients. <...> From 2015 to 2018, the scope of awareness of clinical exams has increased fivefold — Nadezhda Grishina, General Director, Capital Medical Insurance.

As part of the implementation of the three-tier institution of insurance representatives, all major insurance companies have formed federal call centres. This means twenty-four-hour professional support on all matters for the insured <...> This is, of course, a rather serious step towards individual adjustment and personalized work — Andrey Ryzhakov, General Director, Alfastrakhovanie-OMS.

The main problem is to cover 70% with preventive care exams – that is 77 million people; we do clinical exams for 21 million people, and 10 million in health centres. Still, that is more than one and a half medical exams, nearly two medical examinations. And this is where it is difficult to overestimate the help of insurance companies — Oksana Drabkina, Chief Specialist in Internal Medicine, Ministry of Healthcare of the Russian Federation.

Creating the rating of healthcare facilities and insurance companies

When introducing the rating of healthcare facilities, the rating of medical insurance providers must be introduced as well. And it is very important for the patients, so that they knows where to go, how to choose an insurance provider that would not just issue a policy, but that would support the patients, because that is why the patient chose this provider in the first place — Tatyana Golikova, Deputy Prime Minister of the Russian Federation.

Creating a certain indicative rating, a very soft rating of healthcare facilities. It is a useful thing. It precisely helps the supervising organizations to pay special attention to a healthcare facility, on the one hand, and for the medical insurance provider itself to concentrate its efforts for control over a certain medical insurance provider, on the other hand — Vladimir Chistyukhin, Deputy Governor, The Central Bank of the Russian Federation (Bank of Russia).

Ratings should be primarily territory-based. Because many federal companies have their branches. Those branches may differ from one region to another — Alexey Reshetnikov, Director, Rostov Region Compulsory Health Insurance Territorial Fund.

Strengthening the liabilities of insurance companies

There is an agreement on financial provision, it stipulates certain penalties for non-compliance with these conditions, but we would also like to propose that territorial funds should have the opportunity to terminate the agreement on financial provision if the insurance company does not fulfill its functions — Alexey Reshetnikov, Director, Rostov Region Compulsory Health Insurance Territorial Fund.

I support what my colleagues said about the possibility of agreement termination in case the terms are not fulfilled — Vladimir Zelensky, Director, Moscow Compulsory Health Insurance Territorial Fund.

Monitoring the quality of medical care

Thematic targeted medical expert reviews. They are associated with the level of morbidity that we see in the regions that are at risk. That is primarily oncology and cardiovascular diseases. The volume of thematic expert reviews grew in 2018 <...> by 30% <...> We systematized all the expert work and together with the National Medical Chamber we released the Cancer Care Defects map, which is a reference guide for all experts — Nadezhda Grishina, General Director, Capital Medical Insurance.

The material was prepared by the Russian news agency TASS