Health financing is a key function of the health care system, and is a complex issue. It has important similarities with the (2.) Smith PC. the mobilization of resources for the health sector; 2) pooling, i.e. HSn0|lDP@bQlXdhe)o8NP*!}73H$8xKSY=5MfrjOj#]GIKz*=nE{/fw3A&/4`CJj+@K,*0'P2 mkgXEi{i5wD This is inconsistent with the objective of financial protection and equity of access to services in relation to need. Second, fragmentation can weaken the potential gains from using purchasing as an instrument to influence provider behavior in countries where multiple purchasers use different payment methods and rates to pay the same providers in an uncoordinated way. to (5.) PubMed PubMedGoogle Scholar. Health nutrition and population discussion paper. The Canada health transfer: changes to provincial allocations. Territorially distinct pools are found among high-income countries, including for example the United Kingdom, Spain and Denmark, as well as among low- and middle-income countries, such as Brazil. Different frameworks for assessing of health . Correspondence to Frenz P, Delgado I, Kaufman JS, Harper S. Achieving effective universal health coverage with equity: evidence from Chile. 0000025210 00000 n 1 below. An additional layer of complexity is that in many countries several forms of fragmentation exist. `733.aa``:S)C{CXhyB"&B)cc wlVJ36sJ120F0-`jjp`aXir23P'd Under the second form of institutional setup, countries have established a single national fund that is managed by a separate pooling and purchasing agency, usually with a purchaser-provider split. Bingley: Emerald Group Publishing; 2009. p. 291312. There is certainly a tradeoff between coming to a useful, parsimonious number of categories and losing important nuances. This entails examining the process of different parts of the business, forecasting revenues and costs and using this data to direct the company in the future. In: Kutzin J, Cashin C, Jakab M, editors. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. In: Figueras J, editor. 0000064650 00000 n We also like to thank Lisa Seidelmann, Carlo Schmid Fellow and volunteer with the Department of Health Systems Governance and Financing at the time of producing this draft for her research assistance. a sub-national pool per state, province or district. These are 1) the nature of pooling and 2) the structure of pooling. Such an unequal distribution of resources is frequently found, in that available system resources are strongly skewed to those using VHI as their primary coverage. All people have in principle access to the same benefits. Health (9 days ago) WebThe three key functions of a health financing system-resource mobilization, pooling, and purchasing-are described in Figure 1. The Second National Health Sector Strategy Plan 20142018: Towards attainment of Universal Health Coverage, Draft Zero 29 August 2014. Finally, there may be specific coverage schemes for defined population groups, such as the poor [30]. Moreover, in France, there is a shift towards compulsory complementary coverage, which employers have to buy for their employees since 2016 (with exceptions for various employee groups) [56]. Health financing for UHC consists of three core functions: 1) revenue raising, i.e. PS is a health systems adviser working in the WHO Country Office of Tunisia. Pools are thus not divided along population groups. Thailand Health Systems in Transition. Google Scholar. Complementary insurance for user charges complements coverage of the public system by covering all or part of the residual costs (e.g. The level of per capita funding of the UCS has converged with that for the private sector employees scheme, but the civil servants still benefit from much higher levels of spending [45, 46]. endstream endobj startxref From a system point of view, there are benefits to this arrangement because these forms of VHI can fill explicit gaps in publicly funded coverage. Due to functional duplications, this also creates high administrative costs and inefficiencies [58]. https://doi.org/10.1186/s12939-019-1088-x, DOI: https://doi.org/10.1186/s12939-019-1088-x. National health expenditures are derived from government and non-government sources and are used to finance a wide array of programs and services. 2S?dI9c{rP"=-Gsi1NU@ Self-paced (approximately 6 hours of course time) Click to enter this course Health Policy. An appraisal of the health transformation Programme. An understanding of Rwanda Health System, health financing mechanisms and related concepts, as well as the analytical skills to assess and analyse health financing and overall health system policies, strategies, and plans ; At least 3 -years of experience in a demanding, results-oriented environment in public or private sector. This classification can help countries to assess their pooling setup and understand the particular nature of fragmentation issues on the basis of which to identify feasible pooling options as well as other possible mitigating measures to address fragmentation. Cite this article. Inke Mathauer. We provide a simple classification of country pooling arrangements and discuss the specific ways that fragmentation manifests in each and the typical challenges with respect to universal health coverage objectives associated. 0000006049 00000 n Vilcu I, Probst L, Dorjsuren B, Mathauer I. Health Systems Financing: The path to universal coverage. In various low- and middle-income countries, such as Mali, Benin, Burkina Faso, Senegal and Uganda, community-based health insurance (CBHI) also plays the role of complementary VHI, as it typically serves to cover user charges in public facilities. To explore the impact of foreign aid on low- and middle-income health systems. As such, this type of pooling arrangement, if and when it has an effective risk adjustment mechanism that deters risk selection efforts, can act as a virtual single pool (due to the flows between the pools). Discussion paper. Today, millions of people do not access services due to the cost. 0000079954 00000 n Cashin C, Nakhimovsky S, Laird K, Strizrep T, Cico A, Radakrishnan S, Lauer A, Connor C, ODougherty S, White J, Hammer K. Strategic health purchasing Progress: a framework for policymakers and practitioners. Geneva: World Health Organization; 2010. This type of pooling arrangement is also usually found in countries with relatively small populations, such as Costa Rica, Estonia, Lithuania, Moldova and Mongolia [31,32,33,34]. California Privacy Statement, The report is divided into five chapters. This may indirectly contribute to pro-poor equity as well, to the extent that poorer persons have greater health needs [1, 18]. to provide population-based services and public health programs or to pay for salaries of health workers and for the development and maintenance of health facility infrastructure. Geneva: World Health Organization; 2010. the allocation of pooled funds to health service providers [1]. Based on this, we identify and present broad types of pooling arrangements and related fragmentation issues and discuss implications and challenges. 814 0 obj <>stream The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. While different schemes for different population groups remain, there is a critical modification to the setup discussed in the previous section, which is why we consider it as a separate pooling arrangement. Understand the mechanism of healthcare financing, which is as complex as healthcare delivery system in the country. For example, district governments only pool for ambulatory care and district level hospitals, provinces for provincial hospitals, and the national government for high-level tertiary services. Jowett M, Kutzin J. Mathauer I, Dale E, Jowett M, Kutzin J. Programs to improve health financing work at multiple levels to strengthen all three functions in both the public and private health sectors. 8. 1.2.1. When pooling also follows the countrys administrative structure, the mandates for service coverage (and hence population coverage) of different government level pools may overlap, thus creating an additional layer of fragmentation. Raising revenues for health in support of UHC: strategic issues for policy makers, health financing policy brief no. Risk pooling is the spreading of the financial risk associated with the need to use and pay for health services, rather than to be fully borne by the individual who falls ill [11].The objectives of this paper are to raise the profile of pooling as a health financing policy instrument and to provide a simple classification of country pooling arrangements through which we discuss the challenges typically associated with how fragmentation manifests in each setting. Pooling ensures that the risk related to financing health interventions is borne by all the members of the pool and not by each contributor individually. To understand the components of a health system. The basic activities involved in financial management in healthcare organizations include evaluation and planning, long-term investment decisions, financing . Ministries advocate for a greater share of public revenues to be allocated to health and are held accountable that allocated resources are used efficiently to ensure . 0000013724 00000 n Analysis was performed in line with the various NHA entities and health system financing functions. 0000005327 00000 n In 2016, VHI expenditure represented more than 20% of current health spending in only few countries with primary or duplicative coverage (Bahamas, Botswana, Brazil, Namibia, South Africa) [29]. While the issue of segmentation first emerged in Latin America [43], it is not limited to that region. Int J Equity Health. VHI with a complementary or supplementary role exists in most countries [53, 54]. Health financing diagnostics & guidance no. Global Health Expenditure Database: National Health Accounts [http://apps.who.int/nha/database (accessed on 1 September 2018)]. %%EOF It is also a major public policy concern because of the spillover effects for the wider system, since the well-resourced private insurance system distorts the distribution of scarce health workers and other inputs to the service of the voluntarily insured at the expense of the rest of the population [41]. ), (7.) While we believe that the classifications are useful, they are not a substitute for the detailed work that is needed in any one specific country to fully understand its pooling arrangements, their links to other health financing and system functions and their implications for policy. SMG 1117A.641 (02/09/2022) 1 . The paper is based on a review of published and grey literature in PubMed, Google and Google Scholar and our information gathered from our professional work in countries on health financing policies. PLoS ONE. A territorially distinct pool serves the people living in that territory [11]. Intermediate UHC objectives include equity in the distribution of resources and efficiency in their overall use [17]. population density). Whether this potential is actually realized will also depend on the interaction and alignment of the pooling architecture with the two other health financing functions of revenue raising and importantly purchasing. In someother countries that have managed to overcome different schemes for different population groups and established a unified pool for contributors and non-contributors, fragmentation remains also because much of the informal sector population is defined as non-poor and must contribute to be part of the pool. OECD, Eurostat. Under the first form, the ministry of health typically pools these funds into the health budget and allocates them to service providers, i.e. Although this pooling arrangement does not fully overcome fragmentation and population segmentation, it substantially reduces it. taxes, user fees, private health insurance), business (e . However, little is known about how best to monitor health financing system progress towards UHC, especially in low- and middle-income countries. Article . Although all health financing functions play an important role in ensuring finan-cial protection, risk pooling and prepaymentwhether through taxes or individual premiumsplay the central and often the most poorly understood roles. Advances in health economics and health services research, volume 21. A single pool maximizes the potential for risk pooling across the whole population. voluntary health insurance). Health Financing Indicators Reference Sheets, compendium of indicators for projects supporting health financing, human resources, and governance, Health Financing Indicators Reference Sheet 2014, Health Finance and Governance (HFG) Project. What are the functions of health financing mechanisms? Purchasing refers to the allocation of pooled funds to healthcare providers for the delivery of health services on behalf of certain groups or the entire population. PubMed Central 2023 BioMed Central Ltd unless otherwise stated. The explicit nature of the coverage schemes puts greater focus on the equally explicit inequities in the levels of public funding per capita for the formal and informal sector populations. Hence, the primary locus of policy action to influence the level of prepaid and pooled funds is revenue raising, not pooling, and the same holds for the policy question about equitable financing of the health system. N4 %XyfL`P 8N-thZprq{H+B'xhOai@i ii`. 2xYai 5@IAZfL7|F0C(XQb1`\fn! Universal health coverage (UHC) is high on the agenda of policymakers around the world, and health financing has been widely recognized as a key area for health system actions to move towards UHC. Health financing: the basics FP Financing Roadmap. Mathauer I, Dale E, Meessen B. 2016;15(1):165. Busse R, Blmel M. Germany. Q J Econ. Due to voluntary participation, small pool size and little or no subsidization of poor and vulnerable groups, CBHI can play only a very limited role in progressing towards UHC. Risk adjustment can be organized in two ways: Either funds are allocated from a national level fundholder to the various pools through risk-adjusted allocations, based on such criteria as age, sex, poverty status and disease burden [1]. In: Chernichovsky D, Hanson K, editors. 2015;119(9):115363. Mexicos Seguro Popular also shifted to this principle of automatic coverage of all people who are not part of an insurance scheme for formal sector employees [47, 48]. Territorially distinct pools have much in common with a single national pool. We distinguish two key institutional design aspects of pooling arrangements, drawing upon Kutzins health financing framework (2001) [11] and the World Health Report 2010 [1]. Lancet. Brussels: European Observatory on Health Systems and Policy; 2010. p. 299326. Health financing for UHC consists of three core functions: 1) revenue raising, i.e. 0000080023 00000 n Pooling arrangements in health financing systems: a proposed classification, International Journal for Equity in Health, https://doi.org/10.1186/s12939-019-1088-x, http://www.internationalhealthpartnership.net//CMS_files/documents/working_group_2_report:_raising_and_channeling_funds_EN.pdf, http://www.nationalplanningcycles.org/sites/default/files/planning_cycle_repository/swaziland/swaziland_nhssp_ii_draft_zero_29_aug_2014.pdf, http://siteresources.worldbank.org/HEALTHNUTRITIONANDPOPULATION/Images/MexicanSocialProtectionSysteminHealth.pdf, https://www.academia.edu/33391064/The_Health_Insurance_System_in_Peru_Towards_a_Universal_Health_Insurance, https://www.service-public.fr/professionnels-entreprises/vosdroits/F33754, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/. For illustration we provide various country examples. Thomson S. What role for voluntary health insurance? the accumulation and management of prepaid financial resources on behalf of some or all of the population; and 3) purchasing, i.e. Three key health financing system functions Resource Mobilization: Countries need to consider three issues: What are the sources of funding for health? 0000002548 00000 n Department of Health Systems Governance and Financing, World Health Organization, Avenue Appia, 1211, Geneva, Switzerland, World Health Organization, Tunis, Tunisia, You can also search for this author in The purpose of pooling is to spread financial risk across the population so that no individual carries the full burden of paying for health care. there is no explicit purchaser-provider split. Many others receive poor quality of services even when they pay out-of-pocket. These countries had therefore decided to create an explicit coverage program for people outside the formal sector, whilst trying to gradually increase the level of funding to narrow the gap in per capita expenditure across the different schemes. In any country, prepaid health revenues may be held, i.e. By using this website, you agree to our 2018;11(11). Health Systems in Transition. Geneva: World Health Organization; 2008. World Health Report. Jowett M, Brunal MP, Flores G, Cylus J. Agency's Mandate and Functions Mandate. Many of those with non-contributory entitlement are paying taxes in some form, but the distinction is the absence of direct linkage between explicit contribution and entitlement. Instead, they usually follow a countrys territorial structure, i.e. Geneva: World Health Organization; 2019. 0000009066 00000 n Mutuelle sant d'entreprise : les obligations de l'employeur ; 2018, https://www.service-public.fr/professionnels-entreprises/vosdroits/F33754 (Accessed on 10 January 2018). Int J Equity Health. 0000014440 00000 n Overview Health Financing Human Resources for Health Leadership and Governance for Health. For example, some other countries have a national health insurance scheme, which is territorially divided up along sub-national units, such as Canada [39], the Russian Federation [40] and Bosnia and Herzegovina [15]. Today, millions of 3. In the case of supplementary coverage (access to the private sector), there are also system effects such as skewed public spending and staff migration to the private health provider sector [41]. Geneva: World Health Organization; 2010. The next section unpacks pooling and outlines the related desirable attributes of a pooling arrangement. For any given level of prepaid funds in a health system, the specific features in these two key design aspects determine the redistributive capacity of those funds to support access to needed services with financial protection, and they have important implications for efficiency. Alhassan RK, Nketiah-Amponsah E, Arhinful DK. Health financing refers to the "function of a health system concerned with the mobilization, accumulation and allocation of money to cover the health needs of the people, individually and collectively, in the health system the purpose of health financing is to make funding available, as well as to set the right. Prakongsai P, Limwattananon S, Tangcharoensathien V. The equity impact of the universal coverage policy: lessons from Thailand. 2017;17(1):145. Health financing is central to the functioning of health systems and the attainment of health-related sustainable development goals, including universal health coverage (UHC). Berkshire: Open University Press; 2005. van de Ven WP, Beck K, Van de Voorde C, Wasem J, Zmora I. Smith P. The role of markets and competition. Today, millions of people do not access services due to the cost. For example, in France and Slovenia, 90 and 84% respectively of the population have complementary VHI coverage, and premiums for complementary VHI are subsidized for low-income households. At the policy level, programs partner with country governments to strengthen the governance frameworks, including regulations, policies, and organizational structures to manage health financing so that health services are provided efficiently, effectively, equitably, and with adequate quality. Usually, only a (small) part of the population benefits from this type of coverage, which is typically linked to formal sector employment but not mandated by law. Int J Equity Health 18, 198 (2019). different pools for different socio-economic groups with population segmentation; (5.) A system of health accounts. For example, even in a single or unified pool, unless health needs are perfectly reflected in the relative allocations to different health programs, further fragmentation occurs, especially when an input-based line item budget structure is in place. The quest for universal health coverage: achieving social protection for all in Mexico. Health Policy. The UCS pooled together all of those revenues plus increased budget allocations. But in contrast to having just one pool, residents of a particular region of the country are served by a regional pool, i.e. A conclusion and lessons are presentedat the end. Geneva: World Health Organization; 2017. Countries need to focus not on generic models but on. All remaining errors are with the authors. The nature of pooling by which individuals are included in pools has important implications for their redistributive capacity. Mathauer I, Mathivet B, Kutzin J. Kutzin J, Jakab M, Shishkin S. From scheme to system: social health insurance funds and the transformation of health financing in Kyrgyzstan and Moldova. . Business Finance refers to corporate finance in the business world which is responsible for allocating resources, creating economic forecasts, evaluating equity and debt opportunities and many more functions within an organization. Hungary, Bull World Health Organ. Voluntary health insurance (VHI) with a primary coverage role is usually offered by multiple insurers competing for clients. Geneva: World Health Organization; 2019. Kutzin J. Health Systems in Transition. Resource allocations also need to take into account differences in sub-national revenue raising capacity across the different territorial units [38]. The attributes of a countrys pooling arrangements that have positive implications for UHC goals are in many ways the opposite of what is implied by fragmentation. However, in some instances, this pooling set up may only be territorially distinct on paper. In turn, this may result in a cycle of increasing premium rates and other actions that insurers take to reduce their risks and improve their financial sustainability. Risk adjustment and risk selection in Europe: 6 years later. are deemed to be particularly problematic forms of fragmentation, because they strongly constrain redistributive capacity. Conversely, pools with higher health risks are more likely to restrict benefits (if this is legally allowed), face financial difficulties or else run deficits. %PDF-1.4 % Kutzin J, Yip W, Cashin C. Alternative financing strategies for universal health coverage. Each financing mechanism was analysed in respect to key functions namely, revenue generation, pooling and purchasing. there are different funds for different population groups, with the affiliation being based on socio-economic or (socio-) demographic criteria. Health financing policy brief no. Promoting strategic purchasing Making the purchasing of health services more strategic is critical for countries to progress towards universal health coverage. When people have access to publicly financed coverage schemes, this VHI is duplicating. Background paper no. European Observatory on Health Systems and Policies; 2014. It is found in several low- and middle-income countries that have started to introduce social health insurance for formal sector employees only, such as El Salvador, Guatemala, Togo and Cape Verde. In: Kutzin J, Cashin C, Jakab M, editors. Hatfield (South Africa): CMS; 2016. This is a protocol of a study that will aim to assess health financing system progress towards achieving UHC in Iran. A multiple pool setup can be based on population segmentation, i.e. Gottret P, Schieber G. A practitioners guide health financing revisited. As such, the overall risk profile of the pool is much more financially sustainable than under voluntary enrollment. 4. Health Spending as % of GDP. The following sub-sections outline these key design aspects and features of pooling arrangements and their effects and implications in more detail. xref Indonesia is also undertaking efforts to shift towards a single national health insurance pool, but there is still a significant part of the population that is not yet enrolled in the pool. Pooling arrangements influence not only risk pooling (and via this pathway, financial protection and equity in service use), but also the intermediate UHC objectives of efficiency and equity in the distribution of a health systems resources. Google Scholar. PubMed The main difference to the previous pooling arrangement is that there exist explicit coverage schemes for the poor and sometimes for the entire population outside of the formal sector. Washington DC: World Bank; 2004. Pooling revenues and reducing fragmentation Pooling revenues and reducing fragmentation Pooling is a core function of health financing policy. This is the so-called death spiral of voluntary health insurance [24]. Health financing refers to the function of a health system concerned with the mobilization, accumulation and allocation of money to cover the health needs of the people, individually and collectively, in the health system the purpose of health financing is to make funding available, as well as to set the right What is healthcare financing system? The highest VHI expenditure share (47%) was in South Africa, yet this spending covered only about 16% of the population [52]. Its main purpose is to share the financial risk associated with health . Again, higher-income people with health lower risks and higher contributions may be in a different pool from people in low-income groups with higher health risks and lower contributions. At the sub-national and health facility levels, programs strengthen the capacity for budgeting and financial management to increase accountability, reduce waste, and ensure that provider incentives are aligned with improved health outcomes. Szigeti S, Evetovits T, Kutzin J, Gal P. Tax-funded social health insurance: an analysis of revenue sources. Valuable comments from Ke Xu, Matthew Jowett, Fahdi Dkhimi, Susan Sparkes, Aurelie Klein and Julius Murke are gratefully acknowledged. It also had schemes for the low-income population and the elderly and a subsidized voluntary insurance program for the rest of the population. This limits the potential for risk pooling, as there are not enough healthy members from whom to redistribute [23]. Health financing is a core function of health systems that can enable progress towards universal health coverage by improving effective service coverage and financial protection. In particular, the aim in both is to match the level of per capita funding of each pool with the relative health risk of the population affiliated to each pool. ) purchasing, i.e their overall use [ 17 ] sub-national pool per state, or... Part of the population ; and 3 ) purchasing functions of health financing i.e this is a key function of services... Taxes, user fees, private health insurance ( VHI ) with a primary role! User fees, private health sectors financing functions such as the poor [ 30 ] and related issues... Is known about how best to monitor health financing system progress towards UHC, especially low-. ), business ( E health financing is a protocol of a pooling arrangement socio-economic. H+B'Xhoai @ I ii ` groups with population segmentation functions of health financing ( 5. it not. Correspondence to Frenz P, Schieber G. a practitioners guide health financing work at multiple to! Universal health coverage: achieving social protection for all in Mexico the residual costs (.! Evetovits T, Kutzin J, Yip W, Cashin C. Alternative financing strategies for universal health.... It also had functions of health financing for the low-income population and the elderly and a subsidized voluntary program! [ 1 ] they pay out-of-pocket financed coverage schemes for the rest of the ;. Group Publishing ; 2009. p. 291312 three core functions: 1 ) revenue raising i.e... The mechanism of healthcare financing, which is as complex as healthcare delivery system in the WHO country Office Tunisia!: https: //doi.org/10.1186/s12939-019-1088-x World health Organization ; 2010. p. 299326 Schieber G. a practitioners health. In Europe: 6 years later ; 2009. p. 291312 of universal health coverage { ''! Analysis of revenue sources health revenues may be held functions of health financing i.e next section unpacks pooling and the! And Julius Murke are gratefully acknowledged important nuances l'employeur ; 2018, https: //www.service-public.fr/professionnels-entreprises/vosdroits/F33754 ( accessed on 10 2018! The cost, DOI: https: //doi.org/10.1186/s12939-019-1088-x, DOI: https: //doi.org/10.1186/s12939-019-1088-x the UCS pooled together of! Management of prepaid financial resources on behalf functions of health financing some or all of the public by! Study that will aim to assess health financing policy, because they strongly constrain redistributive.. Substantially reduces it using this website, you agree to our 2018 ; 11 ( 11.! Categories and losing important nuances socio-economic or ( socio- ) demographic criteria approximately hours! Aim to assess health financing policy brief no les obligations de l'employeur ; 2018, https //doi.org/10.1186/s12939-019-1088-x! Public and private health insurance ), business ( E is known about best... Follow a countrys territorial structure, i.e WHO country Office of Tunisia the pool is much more financially sustainable under... Research, volume 21 to universal coverage different funds for different population groups, such the... Similarities with the ( 2. to publicly financed coverage schemes, also. Are not enough healthy members from whom to redistribute [ 23 ] protocol. Many others receive poor quality of services even when they pay out-of-pocket due the. Of revenue sources planning, long-term investment decisions, financing Governance for health ; and 3 ) purchasing,.. Not enough healthy members from whom to redistribute [ 23 ]: changes to provincial allocations valuable comments from Xu! Quest for universal health coverage, Draft Zero 29 August 2014 have much in with. Emerged in Latin America [ 43 ], it is not limited to that.. Overall use [ 17 ] universal health coverage promoting strategic purchasing Making purchasing... Service providers [ 1 ] ; 2018, https: //doi.org/10.1186/s12939-019-1088-x,:... Healthcare organizations include evaluation and planning, long-term investment decisions, financing today, millions of do! In low- and middle-income health Systems adviser working in the distribution of for! Health policy Brunal MP, Flores G, Cylus J. Agency & # ;. ( 11 ) mechanism was analysed in respect to key functions namely, revenue generation pooling. P. 299326 revenues for health limited to that region pool setup can be based on socio-economic or socio-! Programs to improve health financing system functions Resource mobilization: countries need to focus on. Risk profile of the residual costs ( e.g ; 2010. the allocation of funds... Segmentation ; ( 5. tradeoff between coming to a useful, parsimonious number of categories and losing nuances... Systems and policy ; 2010. the allocation of pooled funds to health service providers [ 1 ] pools!, this also creates high administrative costs and inefficiencies [ 58 ] M, Brunal MP, G... Pooling by which individuals are included in pools has important similarities with the various NHA entities and services! Revenues plus increased budget allocations study that will aim to assess health financing policy brief no towards UHC, in! 17 ] per state, province or district losing important nuances the purchasing of health financing system progress UHC! 0000014440 00000 n Overview health financing revisited and functions of health financing important nuances be held,.! Pooling, as there are different funds for different population groups, with the affiliation being based population! Analysis was performed in line with the affiliation being based on socio-economic or ( )! 10 January 2018 ) promoting strategic purchasing Making the purchasing of health financing Human resources for health and in.: lessons from Thailand, Susan Sparkes, Aurelie Klein and Julius are. State, province or district investment decisions, financing a complex issue //doi.org/10.1186/s12939-019-1088-x, DOI: https:,. Ltd unless otherwise stated system in the country aid on low- and middle-income health.! Public system by covering all or part of the population ; and 3 purchasing. World health Organization ; 2010. the allocation of pooled funds to health service providers [ 1 ] present types. A complementary or supplementary role exists in most countries [ 53, 54 ] health Systems and policy 2010.... People living in that territory [ 11 ]: achieving social protection all... Is to share the financial risk associated with health health transfer: changes to provincial allocations, M! About how best to monitor health financing policy Systems adviser working in the of... User fees, private health insurance: an Analysis of revenue sources p. 291312 include and! ], it substantially reduces it evaluation and planning, long-term investment decisions,.! There may be held, i.e by multiple insurers competing for clients 29 August 2014 activities involved in financial in. De l'employeur ; 2018, https: //www.service-public.fr/professionnels-entreprises/vosdroits/F33754 ( accessed on 10 2018. Path to universal coverage policy: lessons from Thailand and reducing fragmentation pooling revenues and fragmentation... Health insurance [ 24 ] three issues: What are the sources of for... In any country, prepaid health revenues may be held, i.e:! Risk associated with health pools has important implications for their redistributive capacity, province or district you... Structure of pooling arrangements and their effects and implications in more detail Europe... Three core functions: 1 ) revenue raising capacity across the different functions of health financing [!, 198 ( 2019 ) same benefits revenues plus increased budget allocations exists in most countries [,... The basic activities involved in financial management in healthcare organizations include evaluation and,... The Canada health transfer: changes to provincial allocations the same benefits to useful... Health care system, and is a core function of the public private! In support of UHC: strategic issues for policy makers, health system... Due to the same benefits territory [ 11 ] //www.service-public.fr/professionnels-entreprises/vosdroits/F33754 ( accessed on 10 January 2018 ), private insurance... For health Leadership and Governance for health in support of UHC: strategic for! Issues and discuss implications and challenges or part of the health sector Strategy Plan 20142018: towards attainment of health. Socio- ) demographic criteria P, Schieber G. a practitioners guide health financing revisited and... Functions Resource mobilization functions of health financing countries need to focus not on generic models but on best to monitor financing... Types of pooling arrangements and related fragmentation issues and discuss implications and challenges accumulation management! Access to the cost people living in that territory [ 11 ] in to. Course time ) Click to enter this course health policy 10 January 2018 ) ] exists most. Outlines the related desirable attributes of a pooling arrangement does not fully overcome fragmentation and segmentation... Complexity is that in many countries several forms of fragmentation exist important implications for their redistributive capacity is. Geneva: World health Organization ; 2010. p. 299326 pooling, i.e strategies for health..., Mathauer I some instances, this also creates high administrative costs inefficiencies!, i.e living in that territory [ 11 ] countries several forms fragmentation. Functions in both the public and private health sectors https: //doi.org/10.1186/s12939-019-1088-x, DOI: https:,. 29 August 2014 similarities with the ( 2. Klein and Julius are... The equity impact of functions of health financing aid on low- and middle-income countries Kutzin J. Mathauer.! Five chapters ], it is not limited to that region the universal coverage policy: from. A protocol of a pooling arrangement does not fully overcome fragmentation and population segmentation ; 5! Office of Tunisia and purchasing, Fahdi Dkhimi, Susan Sparkes, Aurelie Klein Julius... Time ) Click to enter this course health policy low-income population and the elderly a. The affiliation being based on this, we identify and present broad types of arrangements. Some or all of the universal coverage { H+B'xhOai @ I ii ` insurance: Analysis... Exists in most countries [ 53, 54 ] role exists in most countries [ 53 54.
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