Executive Summary: Leveraging private provision of primary and specialised healthcare in Ukraine.
In 2023-2024, the Ukrainian Healthcare Center (UHC) conducted 11 public discussions and a series of consultations with nearly a hundred experts, doctors, entrepreneurs, and policymakers on integrating the private sector into the Program of Medical Guarantees (PMG). Our findings indicate that private healthcare providers can significantly strengthen the healthcare system, but this requires removing barriers and leveling the playing field for all service providers.
Previously, the private sector in Ukraine referred to commercial clinics that emerged as an alternative to state institutions. However, following healthcare reforms, private facilities could contract with the National Health Service of Ukraine (NHSU) and provide free services under the PMG. Consequently, the primary criterion for participation in the program is no longer ownership type but the ability to deliver high-quality services.
Today, the private sector includes commercial clinics, charitable organizations, international foundations, and volunteer initiatives that provide medical services. The PMG should be structured in a way that patients wouldn’t need to care about the owner or manager of a healthcare facility. What matters most is that the facility fulfills its public mission of providing guaranteed medical services.
What needs to be done to foster the private sector participation in the PMG?
How can we foster private sector growth within the Program of Medical Guarantees?
- Ensure a level playing field. Eliminate preferences for state institutions in equipment procurement, drug supply, and personnel allocation.
- Shift to long-term planning. A 3–5-year forecast for the PMG development will provide private investors with strategic directions for healthcare investment.
- Establish private non-commercial enterprises. This organizational model allows private initiatives to offer services without a profit-driven approach.
- Involve the not-for-profit sector in the PMG. Volunteer and charitable organizations can effectively operate within the program, providing care for socially vulnerable groups.
- Simplify market regulations within the PMG. Certain medical services (such as primary care, rehabilitation, and maternity care) should develop competitively with minimal state intervention.
- Include development costs in tariffs. Private providers must finance their own growth independently, while public institutions receive state-funded equipment. Including depreciation costs in tariffs would create balanced conditions.
- Introduce transparent and standardized PMG tariff calculations. Develop feedback mechanisms between service commissioners and providers through structured procedures for setting tariffs.
If these steps are implemented, by 2030, Ukrainian healthcare will be more open, competitive, and quality-focused, ensuring better access to medical services regardless of a facility's ownership structure.
The number of private providers in the PMG is already growing—by 2024, two out of every five medical facilities (over 1,400 providers) in the program will be private.
The private sector fosters competition, pushing public and municipal institutions to evolve: the more competition, the better the outcomes for patients, doctors, and nurses. Private providers are led by bold, entrepreneurial professionals—many doctors and nurses have started their own practices. Why shouldn’t we give them the opportunity to organize medical care for our patients?
This document was developed by the Ukrainian Healthcare Center (UHC) with the support of the Government of the Netherlands within the project “Leveraging private provision of primary and specialised healthcare in Ukraine.”