Dynamics of Interterritorial Settlements in Mandatory Health Insurance System: Results of 2021–2022 Reforms

Natalya N. Sisigina ()
Additional contact information
Natalya N. Sisigina: Financial Research Institute, Moscow, Russian Federation; Center for Healthcare Quality Assessment and Control, Moscow, Russian Federation

Finansovyj žhurnal — Financial Journal, 2026, issue 4, 100-119

Abstract: In the second half of 2010s territorial mandatory health insurance (MHI) funds faced the rapid growth of spending on medical care provided outside the insurance territory. In 2021–2022 federal regulators introduced a series of amendments to interregional settlements (IRS) mechanism to prevent shortfall in territorial MHI programs. The study aims to assess the impact of 2021–2022 reforms on financial burden related to IRS. Using data from acts on territorial MHI funds’ budget implementation author evaluates regional expenditures and revenues in 2019–2024. To analyze the causes of the changes in spending territorial MHI funds experts’ publications were taken. The findings show significant reduction in both national and regional financial burden. The total spending on IRS fell from 4,9 to 3,7% of subvention for territorial MHI funds. The number of regions with high levels of financial losses (> 5% of federal subvention) decreased from 15–18 in 2019–2020 to 3–6 territories in 2022–2024. A significant contribution in spending lowering came from the transition to direct financing of federal medical organizations.

Keywords: interregional settlements; mandatory health insurance; federal medical organizations; health care finance (search for similar items in EconPapers)
JEL-codes: I13 I18 (search for similar items in EconPapers)
Date: 2026
References: Add references at CitEc
Citations:

Downloads: (external link)
https://www.finjournal-nifi.ru/images/FILES/Journa ... ii/06_4_2026_v18.pdf (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:fru:finjrn:260406:p:100-119

DOI: 10.31107/2075-1990-2026-4-100-119

Access Statistics for this article

Finansovyj žhurnal — Financial Journal is currently edited by Gleb G. Pokatovich

More articles in Finansovyj žhurnal — Financial Journal from Financial Research Institute, Moscow 125375, Russia Contact information at EDIRC.
Bibliographic data for series maintained by Gennady Ageev ().