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On August 15, the National Health Service of Ukraine (NHSU) announced the completion of the "second wave" of signing agreements with PHC providers.

Starting October 2018, 389 non-profit enterprises, 40 private PHC providers and 33 physicians-entrepreneurs will switch to operating under the new healthcare financing model.

During the second wave, the NHSU has signed agreements with PHC providers from all regions of Ukraine, with the most active applicants being from Kharkiv (58 agreements) and Lviv (34 agreements) oblasts. It is worth noting that all municipal non-profit facilities in Kharkiv, Lviv, Sumy, Rivne, Zhytomyr, Ternopil, Chernihiv, Chernivtsi, Ivano-Frankivsk, Mariupol, Mukachevo and many other cities, towns and villages across Ukraine have joined the reform and will receive payments for healthcare services provided to patients in accordance with the agreements with the NHSU. A complete list of agreements signed between the NHSU and PHC providers during the second wave is available in the NHSU tracker service (in Ukrainian).

The newly contracted PHC providers will start operating under the ‘money follows the patient’ principle in October 2018. By then, these facilities will continue receiving financing in the form of government subvention.

"Many oblasts of Ukraine were passive during the first wave, but have changed their attitude to the health reform during the second wave. For instance, Luhansk, Ternopil and Volyn oblasts. We currently have 21 partner in Ternopil oblast. Certainly, the experience of the "first wave" champions has inspired other PHC providers to switch to the new financing mechanism. Operating under the agreements with the NHSU, many health facility leaders managed to raise physicians and staff salaries – some health workers got a 30-50% pay raise. We promised health workers to ensure decent and fair pays and we have kept that promise," commented Oleh Petrenko, head of the National Health Service of Ukraine.

In total, the NHSU has signed agreements with 623 PHC providers serving about 23 million patients, more than 10 million of which have already chosen their doctors.

The exact dates for the "third wave" of signing the agreements between PHC providers and the NHSU will be announced in the near future.

By the end of this year, all PHC providers shall switch to independent management as non-profit enterprises, register in the eHealth system, provide services in full compliance with the approved Procedure and requirements, and sign an agreement with the NHSU. Starting 2019, 100% of payments for the actual primary care services rendered to patients will be made under the NHSU-funded contract-based age-adjusted capitation model.

As at August 6, 2018, every third Ukrainian has signed a declaration with a family doctor, pediatrician or general practitioner. Every second resident of Vinnytsia, Poltava and Kharkiv oblasts has already chosen own doctor.