Compulsory medical insurance expenditures on medical rehabilitation almost doubled in 2022–2024

The largest amount of funds - 43 billion rubles - in 2024 was allocated for medical rehabilitation in a 24-hour hospital, more than 12 billion rubles - in a day hospital and 11.2 billion rubles - in outpatient settings. Compared to 2022, the total increase in funding was 78%.

The Accounts Chamber analyzed the implementation of the federal rehabilitation project in 2022–2024 and assessed the growth in the volume of rehabilitation through compulsory medical insurance, which is one of the project’s target indicators.

It turned out that the largest volume of medical rehabilitation care provided in a 24-hour inpatient setting according to the CSG traditionally falls on the group "Medical rehabilitation of patients with diseases of the central nervous system". In 2022, the volume of these cases in the inpatient setting was 27.3%, in 2023 - 28.1%, in the first half of 2024 - 31%. In second place is the group "Medical rehabilitation of patients with diseases of the musculoskeletal system and peripheral nervous system" - 23.2%, 27.2% and 31.3%, respectively.

In day hospital conditions, the leading cases are in the group “Medical rehabilitation of patients with diseases of the musculoskeletal system and peripheral nervous system”, in outpatient conditions – complex visits regarding medical rehabilitation of patients in the profiles “Traumatology and orthopedics”.

Among the problems that the auditors found was a high level of violations, in their opinion, identified by medical insurance organizations (IMOs) during inspections of cases of medical rehabilitation. In 2022–2024, the amount of financial sanctions applied by IMOs to medical organizations amounted to 893.5 million rubles. This includes non-payment or reduction in payment for medical care totaling 843.8 million rubles and fines of 49.7 million rubles. Separately, in 2024, the amount was about 200 million rubles.

In addition, according to the Accounts Chamber, despite the overall positive dynamics, the allocated volumes are not enough in a number of regions. They are forced to cover the shortage of compulsory medical insurance volumes with their own budgets. And although such a practice is becoming commonplace, especially in high-cost segments, and the Federal Compulsory Medical Insurance Fund insists on the sufficiency of volumes, the Accounts Chamber believes that the Russian Ministry of Health should be concerned with developing a methodology for determining the actual annual need of the population for medical rehabilitation "for the purpose of planning the volume of medical care provided in this profile in the medium and long term."

In 2021–2023, as the Accounts Chamber event showed, the actual need for medical rehabilitation was many times higher than the volume of assistance provided in regions such as the Volgograd, Irkutsk, Kemerovo, and Chelyabinsk regions, the Trans-Baikal, Krasnodar, Krasnoyarsk, and Stavropol territories, the republics of Buryatia, Bashkortostan, Mordovia, Sakha (Yakutia), the Chechen Republic, and the city of St. Petersburg.

Increasing the volume of medical care for medical rehabilitation is one of the priority state tasks until 2030. According to the federal project "Optimal Medical Rehabilitation for Health Restoration" with a budget of about 95 billion rubles, which became part of the national project "Long and Active Life" in 2025-2030, by 2030 the number of patients who underwent medical rehabilitation should increase by 26.5%.