Improving the quality of health care delivery is the goal of medical reform. However, the transformation of the financing mechanism of health care should become the breakthrough in its accomplishment. Particularly, the issues of medical reform financing are of utmost importance for the communities formed in the process of decentralization of power, since in 2018 the changes will affect the primary level of provision of medical services.
The purpose of the article is to identify potential problems and risks of public health financing transformation at the level of the united territorial communities.
The process of transforming the health financing mechanism in 2016-2017 is examined. The adequacy of funds allocated from the state budget to ensure the functioning of medical institutions providing primary health care in the united territorial communities in Lviv region is analyzed. The possible financial and social risks of introducing a new approach to financing primary health care in 2018 are critically assessed.
The budget financing of health care through the use of medical subvention is imperfect and needs reform. An analysis of the use of medical subventions to finance the provision of primary health care at the united territorial communities’ level in 2016 showed that funds allocated from the state budget remained unused in some communities, while others lacked them. The main reasons were: the imperfection of the formula for distributing the medical subvention and the distrust of the population to the medical staff in the primary health care institutions in rural areas due to their low professional level. Changes in the financing mechanism of health care in 2017 did not correct the situation. In 2018, healthcare financing based on the principle of “money going for a patient” will be launched at the level of primary care provision. Despite this, there is a threat of emergence of a number of risks, both financial (the sufficiency of funds to finance medical services and investment expenditures for the development of a network of medical institutions, etc.), as well as of social nature (quality and timeliness of provision of medical services, provision of medical institutions in rural areas, etc.).
The need to reform the financing mechanism of the health care sector is beyond doubt. But, besides this, it is accompanied by a significant amount of both financial and social risks that may have an impact on the effectiveness and efficiency of the reform, especially in rural areas. Therefore, related issues will require in the near future a detailed study and development of measures to eliminate them. 

budget, medical subvention, health care, united territorial community, medical reform