Armenia is embarking on a significant healthcare reform by establishing the State Health Insurance Fund. This initiative, outlined in draft legal acts published on e-draft.am, aims to enhance the efficiency, accessibility, and accountability of healthcare services. The Fund is envisioned as a crucial instrument to accelerate and improve the implementation of Universal Health Coverage (UHC). This reform aligns with Armenia’s national development strategies, including the “Armenia Transformation Strategy 2050,” the Government’s Program for 2021-2026, and the Healthcare System Strategy for 2023-2026, underscoring its strategic importance for the country.
A New Phase of Healthcare Reform: Goals and prospects of the Fund’s establishment.
The establishment of the State Health Insurance Fund is driven by the strategic goal of achieving universal health coverage in Armenia. The primary objectives of the Fund include ensuring the smooth implementation of universal health insurance, developing and testing necessary procedures, building appropriate structural components, recruiting qualified personnel and developing their capacities, and preparing electronic tools essential for a seamless transition to UHC. The Fund is designed to become a cornerstone of healthcare management reform, aimed at creating a more efficient, transparent, and accountable system that serves the needs of all Armenian citizens.
Efficiency and Accountability: Why is the State Healthcare Agency being replaced?
One of the key justifications for establishing the Fund is the need to modernize the existing State Healthcare Agency (SHA). The draft proposes to dissolve the SHA within the Ministry of Health, deeming it an outdated structure that has not undergone systematic reforms despite increased financial flows and the introduction of new tools in the healthcare system. The document notes that the SHA’s efficiency has not been systematically analyzed, leading to management inefficiencies and accountability issues. The Fund is planned to be established under the Law on Foundations, implying the introduction of more flexible and effective management mechanisms, as well as ensuring transparency in the use of financial resources.
Ensuring Universal Coverage: How will the Fund facilitate the implementation of universal healthcare?
The State Health Insurance Fund is intended to be the primary mechanism for ensuring universal health coverage in Armenia. The Fund is tasked with developing and implementing comprehensive healthcare packages accessible to all segments of the population, regardless of social status and income level. This entails providing a broad range of medical services, including primary care, specialized and hospital treatment, as well as pharmaceutical coverage. The Fund will also engage in public awareness and education efforts, promoting the informed use of healthcare services and the importance of preventive measures.
Financial Investments and Expected Outcomes: What is the cost of reform and what results are anticipated?
The establishment of the Fund will require certain financial investments, including renovations of facilities, development of IT infrastructure, personnel salaries, and printing of insurance certificates. Total costs are estimated in the hundreds of millions of AMD, although it is expected that part of these expenses will be offset by reductions in the State Agency’s expenditures. The reform is expected to create additional guarantees for the normal functioning of the healthcare system, increase the stability of financing and the effectiveness of state-funded healthcare programs, and provide preconditions for the proper implementation of healthcare reforms. Ultimately, the reform should improve the quality of services provided to citizens receiving medical care within the framework of the state order.
Key Challenges and Next Steps: What issues need to be addressed in the establishment process?
The process of establishing the Fund involves several critical tasks that need to be addressed in the coming months. These include state registration of the Fund, submission of a list of property to be transferred to the Fund for free and indefinite use, approval of the Board of Trustees’ composition by the Prime Minister, and submission of a draft government decision on the property transfer. Successful resolution of these tasks will be crucial for the rapid and effective launch of the Fund, which in turn will contribute to the successful implementation of the universal healthcare program in Armenia.