The 248th issue of the Reform Index, covering the period from September 23 to October 6, includes four reforms, with the Index value reaching +0.6 points. In the previous issue, the Index stood at +1.04 points. The key event in this release is the resolution on transitioning the National Health Service of Ukraine (NHSU) to a medium-term contracting model with medical institutions.
Graph 1. Dynamics of the Reform Index
Graph 2. Values of the Reform Index and its Components in the Current Assessment Round
Healthcare institutions will transition to a medium-term contracting model with the NHSU, +1.25 points
The Cabinet of Ministers has published a resolution allowing medical institutions, starting on January 1, 2025, to sign contracts with the NHSU under the Medical Guarantees Program for up to three years. Currently, agreements between the NHSU and healthcare institutions are limited to one year.
This option will be available to healthcare facilities providing primary and emergency care, as well as cluster (multidisciplinary hospitals) and supra-cluster healthcare facilities (highly specialized medical institutions that provide care for more complex or rare disease cases).
Information about the Reforms Index project, the list of Index experts and the database of the regulations assessed are available here.
Expert commentary
Pavlo Kovtoniuk, co-founder of the Ukrainian Healthcare Center
“Three-year contracts are undoubtedly a step forward for the healthcare delivery system. They enable both the purchaser (the National Health Service of Ukraine — NHSU) and providers (primary and emergency care centers, hospitals) to plan their operations with a longer-term perspective.
From a market standpoint, this is particularly important for small private providers, such as sole proprietors (FOPs) — family doctors — whose share in service delivery has expanded significantly in recent years. Medium-term agreements with the NHSU are also crucial for fostering investments, particularly in the context of reconstruction efforts.
For the NHSU, medium-term contracts create greater opportunities for active procurement. This facilitates the implementation of long-term development projects in collaboration with medical institutions, the execution of extended policies, and the establishment of goals and performance indicators for providers that require more than a year to achieve.
However, the potential of three-year planning can only be fully realized if the NHSU operates as a capable and competent purchaser equipped to develop effective medium-term procurement strategies. Without this capability, three-year contracting would simply become a matter of duplicating current contracts for two additional years.”
Chart 3. Value of Reform Index components and number of events
Reform Index from VoxUkraine aims to provide a comprehensive assessment of reform efforts by Ukraine’s authorities. The Index is based on expert assessments of changes in the regulatory environment in six areas: Governance, Public Finance, Monetary system, Business Environment, Energy, Human Capital. Information about the Reforms Index project, the list of Index experts and the database of the regulations assessed are available here.
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