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Social health protection in action: 57% of services paid by SHIF were the guaranteed packet - P4H Network

Social health protection in action: 57% of services paid by SHIF were the guaranteed packet

The Social Health Insurance Fund of Kazakhstan has published its annual performance report for 2022 at SHIF website. It includes: 1) SHIF overview; 2) ensuring universal coverage for people under mandatory social health insurance; 3) patient rights protection; 4) ensuring sustainability of SHIF operations; 5) financial reports; 6) work priorities for the future.

The annual review report included the annual financial reports (starting on page 67 of the report in Russia language), which indicated that the administrative expenses have been decreased by 2% compared with 2021, mainly due to reduction in expenses for education and payments to the Board of Directors (pages 77-78); and total revenues were increased by 17.6% from 9 148 million tenge in 2021 to 10 759 million tenge in 2022.

A big focus was made on complying with corporate governance best principles and risk management (pages 47-61), and on modernizing the digital tools, software systems and databases used by the SHIF for its daily work, with details described on pages 63-65 of the published report.

Social health protection in Kazakhstan is ensured due to the dual-package nature of benefits basket: every resident regardless of citizenship has access to the “guaranteed benefits basket” and those insured – to the “insured” package of services. According to the annual report, SHIF spent more than half of its funds for health services on the guaranteed basked (page 29):

  • 1.1 trillion tenge (57%) available to 100% of the residents went to the “guaranteed package” of health services, and
  • about 836 billion tenge (43%) were paid to health care providers for the second tier, “insured package” that is available to 84% of residents.

In total, the volume of healthcare services paid for by the single purchaser SHIF in 2022 was 1.9 trillion tenge (1 936 358 233 000 tenge), which was $305 USD per person per year, using the average exchange rate in 2022.

It is important to note that the guaranteed benefits basket includes ALL of the categories of health services covered by SHIF as described in table 5 on page 29 of the report, while the “insured” benefits basket includes some of the “highly specialized” outpatient and inpatient services, and some portion of the guaranteed services. In other words, every type of care can be funded by the guaranteed basket and the entire population is protected with this, while only some services are placed within the insured basked which is available to those insured, allowing the maximization of social health protection of Kazakhstan’s residents.

Along with this most recent report, the previous annual reports for years 2021, 2020, 2019, 2018, 2017 are published at the SHIF website as well. The publication of annual performance reports which include financial indicators and data is part of the corporate governance principles widely spread in Kazakhstan’s public, quazi-governmental and private sectors.

Reference