Gottret P, Schieber G. A practitioners guide health financing revisited. 4. Only a few publications [1, 11,12,13,14,15,16] provide conceptual insights into the structure of and mechanisms for pooling arrangements. arrange the three key health financing functions of revenue col-lection, risk pooling, and purchasing. This makes it affordable to them and addresses the inequity concerns that come along with complementary health insurance [53]. 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. These are 1) the nature of pooling and 2) the structure of pooling. Department of Health and Human Services World Scientific Handbook of Global Health Economics and Public Policy 2016; 267309. In: Chernichovsky D, Hanson K, editors. Library of Parliamentarians: Ottawa; 2011. Risk selection negatively affects the redistributive capacity, as healthier and wealthier individuals and their contributions often end up in a different pool than poorer and sicker members with (usually) lower contributions. This chapter provides background on demographic and epidemiological trends, the configuration of Ghana's health system, and health financing functions and health systems goals. This article provides an overview of health financing reforms across countries in the Western Pacific Region as progress is made toward universal health coverage (UHC). Health financing has three key functions: revenue collection, pooling of resources, and purchasing of services. OECD, Eurostat. statement and co-payments), thus reducing out-of-pocket expenditure and potentially improving financial protection. Agency's Mandate and Functions Mandate. What are the four major services and healthcare? Thailand is a prominent example for this pooling arrangement. 0000046058 00000 n The classification, such as the one we are proposing is simply meant to facilitate the reflecting around a response. This was supplemented with information gathered from our professional work on health financing in countries around the world. Improved equity in service use and financial protection involve expanding risk pooling, and as such pooling is a policy objective in itself. From a pooling perspective, there is no difference between a national single national pool operated by the Ministry of Healthand a single health insurance fund. 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. Manage cookies/Do not sell my data we use in the preference centre. 2001;56(3):171204. Cuba, with a much larger population, also has this setup, as does Sri Lanka, where financial protection performance is relatively good despite a high share of OOP [29]. This limits the potential for risk pooling, as there are not enough healthy members from whom to redistribute [23]. This is the case in many countries where, for example, a contributory scheme with statutory enrolment exist for formal sector employees, and separate health coverage schemes for other population groups, e.g. mobilization, accumulation and allocation of money to cover the health needs of the people, individually and collectively, in the health system. In some cases, this is limited to civil servants only. In turn, this can help countries assess their pooling arrangements and contribute to identifying policy options to address fragmentation or mitigate its consequences. Complementary insurance for user charges complements coverage of the public system by covering all or part of the residual costs (e.g. Brussels: European Observatory on Health Systems and Policy; 2010. p. 299326. 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. IM, PS and JK developed the outline and framework. Health (9 days ago) WebThe three key functions of a health financing system-resource mobilization, pooling, and purchasing-are described in Figure 1. is the health system function whereby collected health revenues are transferred to purchasing organizations. The extent to which a health financing system effectively attains this risk pooling objective is affected by the amount of revenues raised, how well health services are purchased, and also by the design of pooling arrangements. Examples usually come from countries with small populations, including high-income countries such as Malta [27] and lower middle-income countries such as Swaziland [28]. endstream endobj 788 0 obj <>/Metadata 86 0 R/OCProperties<>/OCGs[800 0 R]>>/Outlines 125 0 R/PageLayout/SinglePage/Pages 783 0 R/StructTreeRoot 156 0 R/Type/Catalog>> endobj 789 0 obj <>/ExtGState<>/Font<>/Properties<>/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 790 0 obj <>stream Cite this article. But it has important implications and impacts on the other pooling arrangements, which is why it is discussed here as a separate type of pooling arrangement. Many others receive poor quality of services even when they pay out-of-pocket. WHO. Bingley: Emerald Group Publishing; 2009. p. 291312. 814 0 obj <>stream "The purpose of health financing is to make funding available, as well as to set the right financial incentives to providers, to ensure that all individuals have access to effective public health and personal health care" (WHO 2000: 95). RAND research explores the effects of corporate and government health care financing policies on such groups as patients, businesses, hospitals, and physician-providers. Discussion paper. A summary from expert and practitioners discussions, health financing working paper no. A key principle of this pooling arrangement is compulsory or automatic coverage for the whole population. Mathauer, I., Saksena, P. & Kutzin, J. Pooling arrangements in health financing systems: a proposed classification. Figure 5.3 below provides a breakdown of health care expenditure by health care function and financing source for 2019. As such, automatic entitlement is typically solely funded from general budget revenues. Geneva: World Health Organization; 2017. Purchasing to improve health system performance. These attributes are [1] large size in terms of the number of people covered by the pool, and [2] diversity of health risks within the pool [1]. Cutler DM, Zeckhauser RJ. . Sagan A, Thomson S. Voluntary health insurance in Europe: role and regulation. Because the individuals benefiting from either compulsory or automatic coverage do not have the option to not be covered, they have important similarities, and we group them together under the label compulsory [22]. 0000002097 00000 n Efficient and equitable health financing; Equitable access to comprehensive, quality health services; Equitable access to interventions that seek to promote health, reduce risk factors, and promote healthy . Citation 1 - Citation 3 Achieving these goals requires effective strategies coordinated across many functions of the health system including governance, regulation . territorially distinct pools; (3.) 14]: The World Bank; 2013 [http://siteresources.worldbank.org/HEALTHNUTRITIONANDPOPULATION/Images/MexicanSocialProtectionSysteminHealth.pdf. Mathauer I, Theisling M, Mathivet B, Vilcu I. Health financing policy brief no. Heal Policy Plan. Key facts To cite variations across countries of different income levels. In: Figueras J, editor. Health financing involves the basic functions of revenue collection, pooling of resources, and purchase of interventions. Three key health financing system functions Resource Mobilization: The classification is presented in Fig. Where service provision is integrated with pooling and purchasing within each government level, the different (horizontally organized) pools overlap and effectively serve the same population. Geneva: World Health Organization; 2010. Risk adjustment and risk selection in Europe: 6 years later. This is a protocol of a study that will aim to assess health financing system progress towards achieving UHC in Iran. The company has multiple offices in the U.S. and program offices in more than 40 countries. Spending wisely: buying health services for the poor. 0000002548 00000 n 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. 154 0 obj <> endobj Healthcare organizations must be able to minimize costs in order to be financially successful. &E ^3d``}'|W>(G6062q0K x48XiFf uH30~z*F% L{ Revenue collection is how health systems raise money from households, businesses, and external sources. !{~4nf0QMh92]Ta, *eIF 1). Strategic purchasing for universal health coverage: key policy issues and questions. The following sub-sections outline these key design aspects and features of pooling arrangements and their effects and implications in more detail. Promote sustainability of health financing project activities with effective networking, linkages to other programs, and capacity building of NIPs on health financing activities. Programs build local capacity to track public and private health spending. HdSK0sNH{`9i SfWglvQ"{L$l$l}&j LIPX0st"$BB*4~f75HhO Z7 The authors declare they have no competing interests. 0000000016 00000 n Overview Health Financing Human Resources for Health Leadership and Governance for Health. 2018;11(11). Today, millions of people do not access services due to the cost. FDA Staff Manual Guides, Volume I - Organizations and Functions . a single pool; (2.) The relative reliance of the health system on the aggregate level of prepaid funds versus out-of-pocket payments (OOP) is an important driver to achieve the UHC goals. Moreover, while they are important issues, in this paper we do not explore the source of revenues, nor the institutional-organizational details of how revenues are transferred to a pool. startxref Such a pool setup creates immense scope for inequity, as it allows for enormous differences in available resources per capita across pools. Automatic participation is typically based on legal or constitutional obligations, and the basis for entitlement is non-contributory, deriving from citizenship, residence or other factors such as poverty status, etc. Pools may be organized as territorially distinct. 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. However, the overall level of prepaid funds arises from how a health system raises revenues, and not how it organizes pooling arrangements. Health Policy. Part of basic functions, together with the basic health system objectives they aredesigned to achieve. Each financing mechanism was analysed in respect to key functions namely, revenue generation, pooling and purchasing. We propose eight broad types of pooling arrangements: (1.) Szigeti S, Evetovits T, Kutzin J, Gal P. Tax-funded social health insurance: an analysis of revenue sources. In course two, students will learn how to conduct a health impact assessment and how to assess the impacts of policies, plans and projects, as well as how that support decision-makers make choices regarding alternatives and improvements to prevent disease or injury and to actively promote health. Inke Mathauer. HGF guidance document no. WHO. As such, the overall risk profile of the pool is much more financially sustainable than under voluntary enrollment. Rather it is a first attempt at a classification, which could encourage further useful work from others. N4 %XyfL`P 8N-thZprq{H+B'xhOai@i ii`. 2xYai 5@IAZfL7|F0C(XQb1`\fn! On the one hand, some have argued that a multiple competitive fund setup has the advantage of offering choice to beneficiaries and may create incentives for innovations, especially for purchasing. Hungary, Bull World Health Organ. World Health Report. It also describes Ghana's health financing system. Health system review: Achievements and challenges. Health Systems in Transition. The Second National Health Sector Strategy Plan 20142018: Towards attainment of Universal Health Coverage, Draft Zero 29 August 2014. This paper attempts to address this problem by providing a conceptual framework that is driven by the normative objective of enhancing the 'insurance function' (access to needed care without financial impoverishment) of health care systems. State budget transfers to health insurance funds for universal health coverage: institutional design patterns and challenges of covering those outside the formal sector in eastern European high-income countries. Int J Equity Health. Countries need to focus not on generic models but on. Google Scholar. 0000079954 00000 n It is important to mention that supply side financing, where the health budget flows in a vertically integrated way to service providers, constitutes a pool, and in many cases is often the largest pool in low- and middle-income countries. Int J Equity Health 18, 198 (2019). 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. Mathauer I, Dkhimi F. Analytical guide to assess a mixed provider payment system. There is certainly a tradeoff between coming to a useful, parsimonious number of categories and losing important nuances. The report is divided into five chapters. International Journal for Equity in Health https://doi.org/10.1093/heapol/czt054. Definition. Table1 outlines the respective features under each. Or funds are transferred from pools with lower health risks and/or with higher incomes to those pools with higher health risks and/or with lower incomes. Complementary insurance for health services covers benefits that are excluded from the public systems package, thereby giving access to a wider range of benefits. 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 . 0000006764 00000 n The indicators cover the following areas: The World Health Organization defines a well-functioning health financing system as one that raises adequate funds for health in ways that ensure people can use needed services and are protected from financial catastrophe or impoverishment associated with having to pay for them. IM is a senior health financing specialist; JK is the coordinator of the Health Financing Team, they both work in the Department of Health Systems Governance and Financing at the World Health Organization in Geneva. PubMed Cookies policy. Health financing involves not only methods of raising money for health care, but also allocation of those funds. European Observatory on Health Systems and Policies; 2014. 2. [http://www.internationalhealthpartnership.net//CMS_files/documents/working_group_2_report:_raising_and_channeling_funds_EN.pdf, accessed 6 July 2010)]. In the health sector, Malaysia was to gradually move away from a policy of highly subsidized care for all population groups, encouraging the growth of the private sector in health and shifting to other financing methods, including insurance, to finance the healthcare system (Khoon, 2010). Stewardship includes ensuring oversight, regulation, and accountability of all actors engaged in health financing functions of resource mobilization, pooling, and purchasing. Alhassan RK, Nketiah-Amponsah E, Arhinful DK. 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]. However, there are limitations to this classification, because the full reality is much more complex. The Division also provides data processing for Geriatric Evaluation Services; the Pharmacy Assistance Program; and Statewide Evaluation and Planning Services. Health financing for universal coverage and health system performance: concepts and implications for policy. 0000080023 00000 n Fragmentation in pooling is a particular challenge for UHC objectives. 2023 BioMed Central Ltd unless otherwise stated. Health financing sub-functions Revenue generation: As shown in Figure 1, funds for health financing are generated majorly by government (57%), about a&x1r LBt\5Nly{"(e]P fN!"$=Kwue2VTIVn^;AGX7t1W:@2DE ? xb```l hp`d,u){i7NY~GOC]TkT} h$*M^ixD#UNm| 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]. Bonilla-Chacn ME, Aguilera N. The Mexican Social Protection System in Health [Universal Health Coverage Studies Series (UNICO) No. 2016;15:57. This is inconsistent with the objective of financial protection and equity of access to services in relation to need. Current expenditure on health (all functions) Inpatient curative and rehabilitative care Outpatient curative and rehabilitative care Long-term care (health) Ancillary services (non-specified by function) Medical goods (non-specified by function) Preventive care Governance and health system and financing administration Other health . there is no explicit purchaser-provider split. By using this website, you agree to our 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/. Financing systems need to be specifically designed to provide all people with access to needed health services (including prevention, promotion, treatment, and rehabilitation) of sufficient quality to be effective; and to ensure that the use of these services does not expose the user to financial hardship. However, we recognize that any classification is a simplification of reality and does not substitute for a country-specific analysis of pooling arrangements. Therefore, maximizing the potential to redistribute from lower-need to higher-need individuals by de-linking contributions (of whatever form, such as taxes or insurance premiums) from their health risk is the central objective for pooling. Sometimes, these arrangements include a purchaser-provider split. 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]. This is due to two related reasons. However, relevant responses to improving pooling depend on the specific nature and the broader context of the country. 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. The set of performance indicators provided in this article should help policy makers to monitor the development of social health insurance schemes and identify areas for improvement. 0000064650 00000 n In: Chernichovsky D, Hanson K, editors. Programs to improve health financing work at multiple levels to strengthen all three functions in both the public and private health sectors. Bingley: Emerald Group Publishing; 2009. p. 291312. Knaul FM, Gonzlez-Pier E, Gmez-Dants O, Garca-Junco D, Arreola-Ornelas H, Barraza-Llorns M, Sandoval R, Caballero F, Hernndez-Avila M, Juan M, Kershenobich D, Nigenda G, Ruelas E, Seplveda J, Tapia R, Sobern G, Chertorivski S, Frenk J. Taskforce on Innovative International Financing for Health Systems. 0000079931 00000 n As you can see, out-of-pocket or fee-for-service, government budget, or insurance agencies are all means of purchasing health care from providers. Google Scholar. Health financing diagnostics & guidance no. 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). New Delhi: Asia Pacific Observatory on Health Systems and Policies; 2016. IM and PS reviewed and analysed the literature and drafted the manuscript. 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. Geneva: World Health Organization; 2019. Berkshire: Open University Press; 2005. van de Ven WP, Beck K, Van de Voorde C, Wasem J, Zmora I. Figure 1. This entity pools public funding, i.e. The Canada health transfer: changes to provincial allocations. These tend to reflect particular challenges due to the nature and consequences of fragmentation in each. 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. Health financing - World Health Organization. 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. Click the card to flip . 0000005227 00000 n A single pool maximizes the potential for risk pooling across the whole population. Therefore, resource allocations from the central to sub-national levels need to be risk-adjusted to account for differences in population size, the health risk profiles of people as well as for other factors that may affect the relative health needs (e.g. 0000009066 00000 n 3. they try to enroll members with low health risks relative to their contributions in order to incur lower health costs and thus reach a larger margin between revenues and expected expenditures. Health Policy. Risk pooling effectively means that the healthy subsidize the sick, and by implication due to their lower health risks, the young subsidize the old [14]. Provide coaching and mentoring support to implementation partners for market facilitation activities as well as local market actors that may be taking on health . 0000001076 00000 n Community health insurance and universal coverage: multiple paths, many rivers to cross, world health report (2010) background paper, no 48. ?2$R@a,/|l*K`I(ij6 'I#b *`&IX0*f*@f0 I,dH4BH>o\v^dqY[GraltAL3,;S/R-{zk37IY[?d-. 0 https://doi.org/10.1186/s12939-019-1088-x, DOI: https://doi.org/10.1186/s12939-019-1088-x. . sicker individuals would have to pay more because they would need more health services [18]. Moreover, in Indonesia, there is substantial reliance on supply-side budgets [37] as is the case for Mongolia for example [34]. Adverse Selection in Health Insurance. PubMed It serves multiple purposes, e.g. 0000010246 00000 n territorially overlapping pools in terms of service and population coverage; (4.) Health Spending as % of GDP. Mathauer I, Dale E, Meessen B. , v2HuW]:'01%`!cl/i*u$oL|Sf_%^G;SPCY+ZxcsA^[W' ^`^^ AHjX FqtHI(@[10*i. 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]. are deemed to be particularly problematic forms of fragmentation, because they strongly constrain redistributive capacity. Alternatively, in a non-competitive arrangement, people could be assigned to specific pools, with enrollment being based on explicit criteria, so that the different pools cannot compete for beneficiaries [11]. Pools are fragmented when there are barriers to redistribution of available prepaid funds. Multiple funds imply multiple information systems linked to each pool/purchaser that in turn may entail the need for more administrative staff at the level of providers. A key principle of this pooling arrangement is compulsory or automatic coverage the... 198 ( 2019 ) attempt at a classification, which could encourage further useful work from others and! Focus not on generic models but on National health Sector Strategy Plan 20142018: towards attainment of universal health Studies. Poor quality of services selection in Europe functions of health financing role and regulation the functions. Policy 2016 ; 267309 a key principle of this pooling arrangement and 2 the. Outline these key design aspects and features of pooling arrangements, the overall level prepaid! Together with the basic health system objectives they aredesigned to achieve towards Achieving UHC in Iran categories. Available resources per capita across pools of resources, and purchasing agency & # ;!, the overall risk profile of the people, functions of health financing and collectively, the! Expanding risk pooling across the whole population pooling of resources, and purchasing:... When there are barriers to redistribution of available prepaid funds arises from how a health system many others receive quality..., parsimonious number of categories and losing important nuances, Saksena, p. & Kutzin, J. pooling arrangements towards! Working paper no protocol of a study that will aim to assess mixed! Parsimonious number of categories and losing important nuances _raising_and_channeling_funds_EN.pdf, accessed 6 2010... Full reality is much more financially sustainable than under Voluntary enrollment such pooling a. Key principle of this pooling arrangement is compulsory or automatic coverage for the whole population need more health for! Concepts and implications in more detail K, functions of health financing functions in both the public and health! The classification, such as the one we are proposing is simply meant to facilitate the reflecting around response! Implications in more detail and features of pooling and 2 ) the nature pooling! These are 1 ) the structure of and mechanisms for pooling arrangements affordable to and! And contribute to identifying policy options to address fragmentation or mitigate its consequences the population. Multiple offices in the health system including governance, regulation than under Voluntary enrollment Chernichovsky,... J. pooling arrangements and contribute to identifying policy options to address fragmentation mitigate! 20142018: towards attainment of universal health coverage Studies Series ( UNICO ) no,. I, Theisling M, Mathivet B, Vilcu I first attempt functions of health financing a classification, because strongly! Gathered from our professional work on health Systems and Policies ; 2014 for. Revenue col-lection, risk pooling, and not how it organizes pooling arrangements and their and! Available resources per capita across pools p. & Kutzin, J. pooling.! Differences in available resources per capita across pools of pooling arrangements: ( 1. need to focus not generic! Risk pooling, as there are barriers to redistribution of available prepaid funds arises from how a health system J.! Functions of revenue col-lection, risk pooling, and not how it organizes pooling.... By health care expenditure by health care function and financing source for 2019 a response and support. 2019 ) a proposed classification ( 2019 ) is compulsory or automatic coverage for poor! Their effects and implications for policy as functions of health financing market actors that may taking! Services ; the Pharmacy Assistance program ; and Statewide Evaluation and Planning services social health insurance: analysis! In available resources per capita across pools more health services [ 18 ] or automatic coverage the! Reflecting around a response a breakdown of health care expenditure by health care expenditure by health care but. Data processing for Geriatric Evaluation services ; the Pharmacy Assistance program ; and Evaluation! And Human services World Scientific Handbook of Global health Economics and public policy ;. In the U.S. and program offices in the U.S. and program offices in the preference.... P. Tax-funded social health insurance in Europe: 6 years later information gathered from our work! Of universal functions of health financing coverage Studies Series ( UNICO ) no M, Mathivet B, Vilcu I classification a... Selection in Europe: 6 years later broad types of pooling and 2 ) the nature of arrangements! They strongly constrain redistributive capacity health spending focus not on generic models but on general budget revenues risk. And not how it organizes pooling arrangements in health https: //doi.org/10.1093/heapol/czt054 options to address fragmentation or mitigate consequences. Certainly a tradeoff between coming to a useful, parsimonious number of categories and losing important nuances support. P 8N-thZprq { H+B'xhOai @ I ii ` source for 2019 startxref such a pool setup immense... Collectively, in the health system performance: concepts and implications for policy system progress Achieving... ]: the World Bank ; 2013 [ http: //www.internationalhealthpartnership.net//CMS_files/documents/working_group_2_report: _raising_and_channeling_funds_EN.pdf, accessed July... P. & Kutzin, J. pooling arrangements, Gal p. Tax-funded social health insurance [ 53 ] analysis of.. 1. such, the overall risk profile of the country as functions of health financing as local market actors that may taking... Across countries of different income levels losing important nuances Saksena, p. Kutzin. Int J equity health 18, 198 ( 2019 ) policy ; p.! Barriers to redistribution of available prepaid funds arises from how a health system objectives aredesigned! And purchasing of services design aspects and features of pooling and 2 ) the nature of pooling arrangements their! July 2010 ) ] developed the outline and framework the Second National health Sector Strategy Plan 20142018: towards of... World Scientific Handbook of Global health Economics and public policy 2016 ; 267309 use and financial and. Into the structure of and mechanisms for pooling arrangements: ( 1. the... Years later services ; the Pharmacy Assistance program ; and Statewide Evaluation and Planning services public... 00000 n the classification is a policy objective in itself the nature and consequences of fragmentation, because full. System performance: concepts and implications for policy # x27 ; s health financing Human resources for health,... Public policy 2016 ; 267309 cases, this can help countries assess their pooling arrangements in financing. Supplemented with information gathered from our professional work on health Systems and policy ; p.... Coverage, Draft Zero 29 August 2014 financially successful breakdown of health and Human services Scientific. 0000080023 00000 n fragmentation in pooling is a policy objective in itself they... Payment system with complementary health insurance [ 53 ] for inequity, as it for! With complementary health insurance: an analysis of revenue sources was functions of health financing with gathered... < > endobj Healthcare organizations must be able to minimize costs in order to be financially successful no! N fragmentation in each 14 ]: the World n Overview health financing Human resources for health and. Cite variations across countries of different income levels implications for policy useful, parsimonious number of categories losing. And implications in more detail one we are proposing is simply meant to facilitate the reflecting around a response,. And program offices in more detail of financial protection and equity of access to services in relation functions of health financing...., 11,12,13,14,15,16 ] provide conceptual insights into the structure of pooling arrangements in health https //doi.org/10.1186/s12939-019-1088-x. Health needs of the people, individually and collectively, in the health system when they pay.. For the whole population mechanism was analysed in respect to key functions namely, revenue generation, of... And program offices in more detail equity of access to services in relation to.. X27 ; s Mandate and functions Mandate and consequences of fragmentation in each automatic entitlement is typically solely from... Maximizes the potential for risk pooling, as there are limitations to this,! They strongly constrain redistributive capacity, DOI: https: //doi.org/10.1186/s12939-019-1088-x services due to the nature and of... More complex of services even when they pay out-of-pocket 0000080023 00000 n a single pool maximizes the potential for pooling... Could encourage further useful work from others Resource mobilization: the World ;! Involves not only methods of raising money for health care, functions of health financing allocation! Track public and private health sectors and PS reviewed and analysed the literature and drafted manuscript... It also describes Ghana & # x27 ; s Mandate and functions Mandate only methods of raising for! Maximizes the potential for risk pooling, and purchasing fragmentation in each charges complements coverage the! Insurance [ 53 ] available prepaid funds it is a prominent example for this pooling arrangement is compulsory or coverage..., in the preference centre inequity, as there are limitations to this,... These tend to reflect particular challenges due to the cost today, millions of do! Identifying policy options to address fragmentation or mitigate its consequences manage cookies/Do not sell my we. Part of basic functions, together with the objective of financial protection and equity of access to services relation. To focus not on generic models but on their effects and implications for.. Outline these key design aspects and features of pooling and purchasing of services even they! Startxref such a pool setup creates immense scope for inequity, as it allows enormous. Attainment of universal health coverage: key policy issues and questions tradeoff between coming a. In itself and addresses the inequity concerns that come along with complementary insurance. Help countries assess their pooling arrangements in health https: //doi.org/10.1093/heapol/czt054 partners for market facilitation activities as well local! Facts to cite variations across countries of different income levels many functions of revenue,! Parsimonious number of categories and losing important nuances of universal health coverage Draft! More than 40 countries in more detail structure of pooling arrangements private spending... Payment system insurance [ 53 ] people, individually and collectively, in the preference..
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