The mission of the National Expert is to:

• Lead and facilitate the Working Group, ensuring effective coordination among NSCTO N.D. Batpenov Hospital, CNSDS, TURAR Healthcare, Expertise France and the International Expert;
• Organize the collection, verification and validation of activity, research, operational, financial, budgetary, tariff and regulatory data required for the analysis;
• Support the development of a five-year medico-economic activity projection for NSCTO N.D. Batpenov Hospital, covering care activity, surgical activity, outpatient and ambulatory care, research and innovation activities, and expected changes in practices and demand;
• Contribute to the analysis of NSCTO N.D. Batpenov Hospital’s current budgetary framework, revenue sources, expenditure structure, tariff constraints and financial flexibility;
• Support the adaptation of international methodologies, including EPRD-type modeling, to the Kazakh context, taking into account CNSDS tariff policies, regulatory constraints and the specific situation of national hospitals;
• Facilitate the identification of tariff, institutional, organizational and managerial levers required to strengthen NSCTO N.D. Batpenov Hospital’s financial autonomy and capacity to service an international construction loan;
• Consolidate the technical outputs of the Working Group in close collaboration with the International Expert, ensuring their local relevance, operational feasibility and ownership by Kazakh stakeholders.

The National Expert acts as the primary interface between local actors (CNSDS, NSCTO N.D. Batpenov Hospital, TURAR Healthcare) and international expert / EF, ensuring that analyses are operationally feasible and aligned with CNSDS tariff policies.

To produce a robust economic and financial analysis enabling NSCTO N.D. Batpenov Hospital to:

         i.            Diagnose its current economic model (activity volumes, revenue streams, costs, tariff constraints, insufficient financing by the Social Health Insurance Fund within the framework of the Guaranteed Volume of Free Medical Care (GVFMC) and the Mandatory Social Health Insurance (MSHI) system, resulting in underutilization of hospital bed capacity).

        ii.            Model prospective scenarios (EPRD-type) to assess the financial sustainability of a self-financed international loan.

      iii.            Identify levers (tariff, organizational, institutional) to improve the hospital’s financial autonomy, prioritizing those under CNSDS jurisdiction (e.g., tariff reforms, ambulatory care recognition).

      iv.            Propose actionable recommendations for NSCTO N.D. Batpenov Hospital, CNSDS, and TURAR, ensuring their political and operational feasibility.

To support the Working Group in producing an integrated medico-economic, financial and tariff analysis enabling Batpenov Hospital to assess the sustainability of its construction project, including the potential servicing of an international loan carried by the MF of the RK.

The analysis will link five-year activity projections, evolution of care practices, scientific-research, education and innovation activities, budgetary framework, revenue sources, tariff mechanisms, operating costs, investment requirements and debt servicing capacity of the MF of the RK. It will also identify the tariff, institutional, organizational and managerial conditions required to strengthen NSCTO N.D. Batpenov Hospital’s financial autonomy while remaining aligned with national health policies and CNSDS responsibilities.

Coordinate local stakeholders:

·       Organize and facilitate WG meetings (bi-weekly) and technical workshops with NSCTO N.D. Batpenov Hospital, CNSDS, and TURAR.

·       Structure the work of the WG around two complementary analytical streams:

o   Stream A: activity, care model, scientific-research, education and innovation and five-year prospective analysis;

o   Stream B: budgetary framework, revenue sources, tariff mechanisms, financial flexibility and debt servicing capacity of the MF of the RK.

·       Ensure that both streams are regularly discussed with NSCTO N.D. Batpenov Hospital and CNSDS and progressively consolidated into a single medico-economic and financial analysis.

·       Ensure active participation of CNSDS in analyzing tariff constraints and validating hypotheses.

Facilitate collaboration:

·       Act as a translator between the international expert’s methodological needs and local realities (e.g., explaining CNSDS tariff rules to EF experts).

·       Resolve operational bottlenecks (e.g., data access, scenario validation by CNSDS).

b.       Data Collection and Analysis

Activity and financial data:

·       Collect historical data (3–5 years) on activity, revenue, and costs from NSCTO N.D. Batpenov Hospital in collaboration with the hospital’s finance department.

·       Identify gaps between current practices and CNSDS standards (e.g., under-valued procedures, billing constraints, tariff constraints, insufficient financing by the Social Health Insurance Fund within the framework of the Guaranteed Volume of Free Medical Care (GVFMC) and the Mandatory Social Health Insurance (MSHI) system, resulting in underutilization of hospital bed capacity).

Activity and Medico-Scientific Projection

·       Support NSCTO N.D. Batpenov Hospital and CNSDS in developing a five-year prospective analysis of the hospital’s activity and positioning, including: expected evolution of care demand in orthopedic and trauma care,

·       implications of new technologies, innovation and specialized procedures, role of research, teaching and national referral functions, consequences for capacity planning, staffing, operating costs, tariff revenues and investment sustainability.

Tariff framework:

·       Document CNSDS tariff rules and reimbursement mechanisms applicable to NSCTO N.D. Batpenov Hospital (e.g., overnight stay requirement for hospital billing).

·       Analyze the impact of these rules on financial sustainability and propose realistic adjustments (in coordination with CNSDS).

·       In coordination with working group members, identify technically realistic tariff adjustments or transitional mechanisms that could support new practices, improve revenue predictability and contribute to the hospital’s capacity to service an international construction loan.

c.        Methodology Adaptation

EPRD Modeling:

·       Adapt the EPRD model (provided by the international expert) to the Kazakh context, integrating:

o   CNSDS tariff data.

o   Local constraints (e.g., limits on revenue diversification).

·       Test scenarios aligned with CNSDS policies (e.g., ambulatory care recognition, short-stay tariff adjustments).

Pedagogical tools:

·       Simplify models and deliverables to ensure they are understandable and usable by CNSDS and NSCTO N.D. Batpenov Hospital.

·       Train local teams (CNSDS, TURAR) on tool usage (e.g., EPRD modeling workshops).