USAID HIV Reform in Action Project Published Findings of the 2018 Capitation Rate Study in Ukraine

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The USAID HIV Reform in Action (HIVRiA) Project published findings of the 2018 Capitation Rate Study in Ukraine. Maksym Duda and Nataliia Kovalenko, HIVRiA Project Advisors, together with Sanjit Puri and Lijia Guo, international experts in the area of ​​health financing innovations, have calculated the capitation rate and prepared the related publication.Starting July 1, 2018, Ukraine will switch to the capitation payment in the primary health care (based on the annual per-patient fixed rate).

In order to determine the actual size of the capitation rate for 2018, the HIVRiA Project, together with the Kyiv School of Economics, collected data from 100 primary health care (PHC) facilities in ten regions of Ukraine. The data included budget indicators of the PHC providers’ performance, gender-age band of the population, number and structure of the PHC providers’ staff, utilization of PHC services by types of services (outpatient visit, home visit) and different populations (children, adults).

The methodology approaches used to calculate the capitation rate for 2018 were based on the best actuarial practices (North American Actuarial Council and American Academy of Actuaries) and included the following steps:

  1. Modeling utilization of services per patient per year
  2. Modeling cost of each visit
  3. Determining size of the capitation rate

The publication based on the study findings includes the following main sections:

  • Introduction, statement of work and findings
  • Overview of input data
  • Methodology for determining the size of the capitation rate
  • Limitations and next steps
  • Sensitivity analysis

According to the study findings, the recommended annual capitation rate for primary health care in 2018 should be approx. 350 UAH.
Download the 2018 Capitation Rate Study in Ukraine from the RESOURCES

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