Transformation of state-business interaction in the context of the development of a value-based healthcare system[Трансформация Взаимодействия Бизнеса И Государства В Контексте Развития Системы Ценностно-Ориентированного Здравоохранения]

Introduction. In the context of socio-economic policy transformation accompanied by the digitalization of public political governance in the Russian healthcare system, growing attention is being paid to value-based approaches that shift the focus from the volume of services provided to measurable health outcomes. The implementation of elements of value-based healthcare is associated with changes in the configuration of interaction between the state and business, highlighting the relevance of this issue and the significance of its political and institutional dimension. The purpose of the article is to analyze the transformation of state-business interaction in the process of developing value-based healthcare instruments in Russia, taking into account current practices and institutional constraints. Materials and methods. The study draws on legal acts, policy and program documents, public statements by government officials, materials from expert events and forums, as well as academic publications. The research employs methods of institutional and political analysis, a comparative approach, and elements of discourse analysis. Results. In Russia, value-based healthcare functions primarily as a political and technological framework for strategic state decisions and has not yet achieved a fully institutionalized form. State-business interaction is shifting from the lobbying of individual decisions toward more complex formats of systemic dialogue; however, internal tension persists between the expansion of partnerships and the strengthening of regulatory control. Key areas of interaction are identified – digital platforms, data analytics, pharmaceutical initiatives, and patient support service models – along with institutional constraints that hinder the transition to outcome-based governance. Conclusions. The transformation of state-business interaction takes the form of a redistribution of political responsibility in the healthcare sector. Business actors expand their presence in the design of governance instruments, expert formats, and the development of analytical solutions, while not gaining formal access to final political decision-making. The article concludes by emphasizing the need for further analysis of mechanisms for aligning interests and redistributing risks in the implementation of value-based healthcare models.