Legislative initiatives proposed by the Ministry of Health, which would, among other things, prohibit private facilities that lease space in state or municipal hospitals from charging patients directly for diagnostic testing services, will limit the public's access to medical services and reduce the volume of such services, according to chief medical director of the Dobrobut medical network Oleksandra Mashkevych.
"The proposed changes could negatively impact patients' access to medical services. If funding conditions do not reflect the actual cost of medical services, some private facilities may refuse to participate in such programs or reduce the scope of their services. As a result, patients may have fewer opportunities to undergo necessary examinations and receive treatment in a timely manner," she told Interfax-Ukraine.
In addition, Mashkevych said "if such facilities are forced to leave the premises of state or municipal healthcare institutions due to new restrictions or the economic unfeasibility of operating under the National Health Service of Ukraine's (NHSU) rates, this could lead to an increase in the cost of services for patients."
"The reason is that operating in separate commercial facilities entails significantly higher costs, particularly for rent, infrastructure maintenance, and equipment operation. Accordingly, these additional costs may be factored into the final cost of services," she added.
Mashkevych believes that the proposed changes could lead to an increase in market prices for CT services.
"If the proposed changes result in some private CT operators ceasing to operate within state and municipal healthcare facilities and being forced to operate in separate commercial premises, this could affect the market price of services. The reason lies in significantly higher operating costs, particularly for rent, utilities, maintenance, and equipment depreciation. Under these conditions, there is reason to expect an increase in market prices for CT services," she said.
At the same time, Mashkevych noted the consistently high demand for CT and MRI services within the Dobrobut medical network – appointments for these exams are booked well in advance.
"This indicates that patients' need for modern radiological diagnostics remains very high, and the healthcare system's current capacity is generally not always sufficient to meet this need promptly. Some patients also choose private medical facilities because of faster access to examinations and better service," she said.
Overall, according to Mashkevych, "it is not economically viable for private medical facilities to perform CT scans under the National Health Service of Ukraine (NHSU) package."
"The current rate does not cover the full cost of the service, as it does not account for a number of important expenses, including rent, utility bills, depreciation, and maintenance of expensive equipment. Therefore, for private clinics, this business model is more of a social mission than an economically viable activity," she said.
As previously reported, in July, the Ministry of Health proposed legislative changes designed to prevent the collection of fees from patients for diagnostic tests using medical instruments at private centers located on the premises of state and municipal healthcare facilities.
The initiative calls for amendments to Article 18 of the Fundamentals of Ukrainian Legislation on Health Care, which, in particular, proposes to prohibit private facilities that rent space in state or municipal hospitals from charging patients directly for diagnostic testing services.
A number of experts in the private healthcare market predict that the adoption of this initiative will limit access to medical services and negatively impact the operations of private clinics.
According to the Ministry of Health, 235 CT scanners worth over UAH 3.36 billion have been delivered to Ukrainian medical facilities since 2020. Currently, Ukraine has a higher number of CT scanners per 1 million people than some European countries. At the same time, in EU countries, the number of scans per machine per day is significantly higher.
Currently, 749 CT scanners are registered in Ukrainian healthcare facilities, including 496 used in facilities that provide free medical care under the State Medical Guarantee program, 396 CT scanners operating in municipal healthcare facilities, while another 58 CT scanners are in use at private facilities and 42 at state-run facilities.
