Since the start of the year, Kazakh medical organizations have received almost 1.8 trillion tenge from the Social Health Insurance Fund. According to the Fund, as of September 23, 1.78 trillion tenge had been transferred to healthcare providers under the guaranteed volume of free medical care (GOBMP) and compulsory social health insurance (OSMS), infohub.kz reports.
Of that sum, more than 1 trillion tenge went to pay for services already rendered, while another 779.7 billion tenge was advanced to medical organizations. The annual financing plan has therefore been fulfilled by roughly 60%.
"Acts totaling 1.391 trillion tenge have been accepted for payment. Taking into account the advances transferred, fulfillment of the annual financing plan stands at around 60%," the Fund said.
The Fund openly acknowledges that delays in closing reporting periods are a problem that recurs year after year. For comparison, as of September 22 last year, fulfillment of the annual plan stood at 59.7%, and in 2024 at 60.7%.
Settlement timelines during the year were affected by changes to regulations, data transfers and the technical readiness of the Health Ministry's information systems.
"To maintain continuous financing for medical organizations, the Fund applied additional advances, partial closure of acts and manual uploading of missing data," the Fund said.
The Social Health Insurance Fund sees the transition to the new Qalqan platform as a systemic solution to the problem. It will allow money for confirmed services to be transferred to hospitals in installments without waiting for lengthy approvals. Test payments totaling 6.2 billion tenge have already been made through the new platform.
Earlier, Kursiv wrote that the Fund had expanded the Qalqan pilot to 16 medical organizations.