The government's current strategy could lead to private healthcare providers being pushed out of the Medical Guarantees Program (PMG), Mykola Skavronsky, deputy CEO of the Synevo Ukraine laboratory network, believes.
"A major obstacle to the operation of private companies in the PMG is the exclusion of new providers from the PMG if they did not previously have contracts. Some private operators are leaving the PMG because of the artificial obstacles being created, while at the same time new private operators have no opportunity to enter the system. In other words, the system is structured in such a way as to artificially push out all private providers over time, while preventing new ones from entering, and thus the balance will change completely, with no private operators left in the system at all," he said during the roundtable discussion "The Future of Healthcare in Ukraine: Challenges, Equal Rules and State-Business Dialogue," held this week.
Skavronsky noted that since 2024, as part of its participation in the PMG, Synevo has provided medical services to nearly 2 million Ukrainians and conducted more than 10 million tests, with a market value of about UAH 2.5 billion, but received only UAH 313 million from the National Health Service of Ukraine (NHSU), which amounts to about 13% of their total market value.
"We are not complaining about these payment volumes; we clearly understand that in matters of such social importance, this is not about profit. We are guided by corporate social responsibility. We are doing this with a long-term perspective in mind. The main idea behind the operation of the PMG was that the money follows the patient, but unfortunately, we have to state that the PMG's basic principle has now changed and sounds like this: the money follows the patient, but only if the patient chooses a state or municipal facility," the Synevo Ukraine representative said.
Skavronsky said that "for the same work, private laboratories receive payment three times lower than municipal laboratories."
According to him, the main obstacles to the operation of private laboratories within the PMG system include the application of reducing coefficients, changes to the terms of operation within the PMG "retroactively," which "effectively gives the regulator the ability to do absolutely anything it wants to create artificial conditions and reduce payments," as well as a lack of transparency in the terms of cooperation, when "the NHSU simply refuses to recognize the fact that we performed the work."
"There is an artificial definition called 'crediting of services.' This is when a doctor issues a patient a referral for five tests, the laboratory performs all five tests, submits the results of those tests to the Electronic Health System, the doctor sees them and prescribes the appropriate treatment, but then, at the end of the month, we receive a report from the NHSU in which only four tests are credited to us. No matter how many inquiries we submit, we have never received clear algorithms or rules according to which one test is credited and another is not," Skavronsky explained.
He said that the NHSU does not count more than 20% of tests performed under referrals within the PMG. At the same time, when developing PMG tariffs for subsequent periods, the NHSU takes into account only credited tests rather than tests actually performed.
"Effectively, we perform 20% more work than the NHSU recognizes. In the first three quarters of 2026 alone, about 700,000 tests that we physically performed, used reagents for and incurred expenses on were not credited to us. But the regulator refuses even to acknowledge, let alone pay for, the fact that this work was performed," the source said.
Skavronsky also said that new providers are excluded from the PMG if they did not previously have contracts.
"There are signs of systemic pressure on private service providers: instead of a partnership in the interests of patients and access to healthcare, we now have these reducing coefficients and a refusal to recognize the work actually performed. These are not the kind of partnership relations we would like to see with the state," he said.
