functions of health financingrentcafe payment options

voluntary contributions from beneficiaries, are prone to adverse selection: people with higher risks are more likely to enroll than people with lower health risks. 2. This overlap turns into duplication of service coverage particularly in big cities, with the main policy consequence being large inefficiencies in the form of excess provider capacity [15]. 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. 0000006764 00000 n There are different classifications for finance functions, and it varies with organization types. Kroneman M, Boerma W, van den Berg M, Groenewegen P, de Jong J, van Ginneken E. The Netherlands: health system review. Pools may be organized as territorially distinct. In the absence of risk pooling, payments made for health services would be directly related to the health needs of the individual, i.e. Raising revenues for health in support of UHC: strategic issues for policy makers, health financing policy brief no. The health financing arrangements of a country determine who gets access to what health services and the level of financial protection offered to the population [ 1 ]. In turn, this can help countries assess their pooling arrangements and contribute to identifying policy options to address fragmentation or mitigate its consequences. To develop a health financing structure capable of addressing the challengesof the future. 2023 BioMed Central Ltd unless otherwise stated. This entity pools public funding, i.e. 2011;13(7):1190. . 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. The on behalf may come from public budgets for specific groups of individuals whose participation is fully or partially subsidized, or it may come from traditional insurance contributions that cover individuals beyond the contributor (e.g. volume18, Articlenumber:198 (2019) Health care administration professionals develop payment plans for patients, negotiate contracts with providers, draft policies, and ensure overall compliance. Health financing involves the basic functions of revenue collection, pooling of resources, and purchase of interventions. They also contribute to system-wide inefficiencies arising from the duplication of responsibilities for managing different pools (with purchasingoften linked to that). PubMed Jowett M, Brunal MP, Flores G, Cylus J. 2016;15:7. . Health Facilities Health facilities in the Philippines include government hospitals, private hospitals and primary . A Review of the National Health Insurance Scheme in Ghana: What Are the Sustainability Threats and Prospects? To cite variations across countries of different income levels. This was, and in some places remains, one of the main drivers of large inefficiencies in the health systems of the ex-USSR countries [15]. Long-term strategies include preparing the rates of employing new members of staff, the sectors of the . Google Scholar. Some countries, such as Rwanda and Ghana, have transformed their earlier CBHI model, which no longer falls under VHI. OECD reviews of health systems: Switzerland 2011. 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. An appraisal of the health transformation Programme. As a result of inadequate diversity of healthier and sicker people, the costs of care for a pool based on voluntary coverage are in principle higher than for the average in the population. "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). Google Scholar. Innovations in health system finance in developing and transitional economies. An additional layer of complexity is that in many countries several forms of fragmentation exist. 0000001076 00000 n Management has five main functions: planning, organising, leading, coordinating and control. In: Figueras J, editor. 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. However, as with any classification, it is a simplification of reality, and the aim is not merely to categorize a country in one type or another. But the key concern is that the existence of multiple pools implies fragmentation. International Journal for Equity in Health Geneva: World Health Organization; 2019. To understand the key challenges to health systems. 0000003940 00000 n [http://www.nationalplanningcycles.org/sites/default/files/planning_cycle_repository/swaziland/swaziland_nhssp_ii_draft_zero_29_aug_2014.pdf. But a system with territorially distinct pools can suffer from fragmentation, if and when their population size or the territory are too small to ensure redistributive capacity, or when sub-national territories have very different levels of average per capita expenditure on health. Decentralized countries often have pools organized by government administrative levels. Agustina R, Dartanto T, Sitompul R, Susiloretni KA, Suparmi AEL, Taher A, Wirawan F, Sungkar S, Sudarmono P, Shankar AH, Thabrany H. Universal health coverage in Indonesia: concept, progress, and challenges. 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. Higher income persons are usually more likely to have this form of VHI [51]. Health nutrition and population discussion paper. https://doi.org/10.1093/heapol/czt054. Today, millions of 2019, 5/393(10166):75102. However, we recognize that any classification is a simplification of reality and does not substitute for a country-specific analysis of pooling arrangements. However, the overall level of prepaid funds arises from how a health system raises revenues, and not how it organizes pooling arrangements. Health financing: the basics FP Financing Roadmap. 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 . 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. In some cases, this is limited to civil servants only. Conversely, there is no population segmentation when coverage and participation in a pool is independent of peoples socio-economic or (socio-)demographic criteria. The agency is typically labelled as a national health insurance fund and constituted as an autonomous public entity. In doing so, policy makers can come closer . Self-paced (approximately 6 hours of course time) Click to enter this course 0000005327 00000 n 2019;97:33548. Common to these low- and middle-income country examples is that they did not manage to merge all coverage schemes into one pool due to the resistance of the formal sector employees for a unified national scheme. A multiple pool setup can be based on population segmentation, i.e. 154 0 obj <> endobj The Canada health transfer: changes to provincial allocations. PubMed 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. 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. 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. However, evidence for efficiency improvement with increased market competition among purchasers is weak [25]. These latter three were replaced by a new health coverage scheme that was introduced in 2002, called the Universal Coverage Scheme (UCS), as a response to growing concerns about the huge differences in level of funding per capita across the schemes and the remaining coverage gap due to the failure of the voluntary insurance to reach much of the informal sector. Many others receive poor quality of services even when they pay out-of-pocket. Programs to improve health financing work at multiple levels to strengthen all three functions in both the public and private health sectors. to (5.) statement and Healthcare organizations must be able to minimize costs in order to be financially successful. Click the card to flip . Copenhagen: World Health Organization, on behalf of the European Observatory on Health Systems and Policies; 2010. 1: World Health Organization, 2015. endstream endobj 168 0 obj<>stream 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. Its main purpose is to share the financial risk associated with 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. 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. Health financing involves not only methods of raising money for health care, but also allocation of those funds. Health Financing in Ghana. Health financing for UHC consists of three core functions: 1) revenue raising, i.e. Google Scholar. 0000014993 00000 n The quest for universal health coverage: achieving social protection for all in Mexico. Council for Medical Schemes (CMS). hmo6 The authors declare they have no competing interests. 0000005227 00000 n 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. 0 Collectively, they work to meet the physical and mental health care needs of Australians. Different frameworks for assessing of health . As you know, there is a lot that you can find. 0000074834 00000 n Health financing diagnostics & guidance no. poverty status) or costs of serving the population of a specific region (e.g. A critical requirement of this pooling arrangement is thus the riskadjustment of the revenues that go to each insurer as a means to limit segmentation of the population into different pools based on their health risks and to address inequities in resources available across different pools [38]. the mobilization of resources for the health sector; 2) pooling, i.e. Klasa K, Greer S, van Ginneken E. Strategic purchasing in practice: comparing ten European countries. Health Systems Financing: The path to universal coverage. 0000006049 00000 n are deemed to be particularly problematic forms of fragmentation, because they strongly constrain redistributive capacity. 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. Health Policy. The report is divided into five chapters. Health financing policy brief no. Maximum redistributive capacity from prepaid funds is achievable in these settings. 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. This can help countries assess their pooling setup and contribute to identifying policy options to address fragmentation or mitigate its consequences. 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. Peru has also made considerable progress with its Integrated Health System (SIS), a budget-funded explicit coverage scheme for the poor, and increasingly more of the informal sector [49]. complementary or supplementary voluntary health insurance. Table1 outlines the respective features under each. Sagan A, Thomson S. Voluntary health insurance in Europe: role and regulation. there must be a specific contribution made by or on behalf of the covered person. Fragmentation is further aggravated, as a small part of the better-off population is often enrolled in commercial voluntary health insurance, whilst a small share of people in the informal sector may enroll in voluntary community-based health insurance schemes [41, 42]. All people have in principle access to the same benefits. , v2HuW]:'01%`!cl/i*u$oL|Sf_%^G;SPCY+ZxcsA^[W' ^`^^ AHjX FqtHI(@[10*i. Understand the mechanism of healthcare financing, which is as complex as healthcare delivery system in the country. Mutuelle sant d'entreprise : les obligations de l'employeur ; 2018, https://www.service-public.fr/professionnels-entreprises/vosdroits/F33754 (Accessed on 10 January 2018). What are the three main functions of health financing? In the early 1990s, Thailand had a scheme for civil servants and another scheme for private sector employees. 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. a single pool; (2.) 2012;380(9849):125979. 0000035307 00000 n health financing functions and objectives . Raising and channeling funds: Working Group 2 report, 2009. We propose eight broad types of pooling arrangements: (1.) Heal Policy Plan. Vilcu I, Mathauer I. Smith P. The role of markets and competition. Mathauer I, Dale E, Jowett M, Kutzin J. In any country, prepaid health revenues may be held, i.e. The third function of health care financing is purchasing of services. different pools for different population groups, with explicit coverage for all; (6.) PubMed Central We examined the nature and structure of pooling in more than 100 countries across all income groups to develop the classification. Risk adjustment and risk selection in Europe: 6 years later. The National Health Insurance Program was established to provide health insurance coverage and ensure affordable, acceptable, available and accessible health care services for all citizens of the Philippines. 1997;41:136. Baeza CC, Packard TG. 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. Service public pro. A desciptive framework for country-level analysis for health care financing arrangements. 1). The finance department functions like bookkeeping, budgeting, forecasting, and management of taxes, and the finance manager functions like financial report preparations contribute to the overall financial wellbeing of an entity. All authors have read and approved the final manuscript. Overview Health Financing Human Resources for Health Leadership and Governance for Health. %%EOF Health Care Financing Administration is a fast-growing industry providing support services to healthcare research, insurance companies, and self-insured entities. Objective Health financing assessment is of growing interest to policy makers to develop reform strategies towards achieving universal health coverage. This is followed by an outlineof the key institutional design aspects of pooling arrangements and how these can create fragmentation. Cite this article. Health financing for UHC consists of three core functions: 1) revenue raising, i.e. 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. #mHGilaa^{'D. family members). Known for its rigorous approach to solving complex challenges, Abt Associates is regularly ranked as one of the top 20 global research firms and one of the top 40 international development innovators. The UCS pooled together all of those revenues plus increased budget allocations. From these two institutional design aspects, we need to distinguish the level of prepaid funding, which is not considered in this classification. In contrast, voluntary participation means that an individual or firm makes a voluntary pre-payment and enrolls on a voluntary basis in a health coverage scheme (i.e. Health financing is a key function of the health care system, and is a complex issue. 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. 2007;83(23):16279. Lancet. World Scientific Handbook of Global Health Economics and Public Policy 2016; 267309. 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. Based on this, we identify and present broad types of pooling arrangements and related fragmentation issues and discuss implications and challenges. These are 1) the nature of pooling and 2) the structure of pooling. Finally, there may be specific coverage schemes for defined population groups, such as the poor [30]. Today, millions of people do not access services due to the cost. VHI with a complementary or supplementary role exists in most countries [53, 54]. 2018;11(11). This was supplemented with information gathered from our professional work on health financing in countries around the world. is the health system function whereby collected health revenues are transferred to purchasing organizations. Mathauer I, Mathivet B, Kutzin J. In: Chernichovsky D, Hanson K, editors. Sparkes S, Durn A, Kutzin J. It serves multiple purposes, e.g. Spending targets for health: no magic number. PubMed The Second National Health Sector Strategy Plan 20142018: Towards attainment of Universal Health Coverage, Draft Zero 29 August 2014. Health Policy. Finally, it is important to keep in mind that while pooling reforms are needed to enhance redistributive capacity, realizing the gains set by the potential of a pooling arrangement requires more than pooling. Geneva: World Health Organization; 2017. The extent to which the potential redistributive and efficiency gains established by a particular pooling arrangement are realized in practice depends on its interaction and alignment with the other health financing functions of revenue raising and purchasing, including the links between pools and the service benefits and populations they cover. 799 0 obj <>/Filter/FlateDecode/ID[<0390BB992C88AA479032C87A0FBB6257><540FDF402BF7DC42AD0DD7B5A9813B14>]/Index[787 28]/Info 786 0 R/Length 75/Prev 299315/Root 788 0 R/Size 815/Type/XRef/W[1 2 1]>>stream Washington DC: World Bank; 2006. Analysis was performed in line with the various NHA entities and health system financing functions. 0000002097 00000 n Key facts there are different funds for different population groups, with the affiliation being based on socio-economic or (socio-) demographic criteria. PubMedGoogle Scholar. Vilcu I, Probst L, Dorjsuren B, Mathauer I. 2016;15:57. In: Kutzin J, Cashin C, Jakab M, editors. Although this pooling arrangement does not fully overcome fragmentation and population segmentation, it substantially reduces it. 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. It has important similarities with the (2.) Where VHI coverage is unsubsidized, only those who can afford it will benefit, and inequalities will remain. 2001;56(3):171204. 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. 154 39 Taken quite literally, perhaps no country has only one single pool. Google Scholar. Complementary insurance for user charges complements coverage of the public system by covering all or part of the residual costs (e.g. a. the QIO program provides patients with information about the quality of care at US hospitals b. the QIO program focuses on helping medicare and medicaid beneficiaries c. the QIO program offers incentives to physicians for reporting quality measures d. the QIO program allows medicare beneficiaries to file complaints about quality of care Available from: https://www.academia.edu/33391064/The_Health_Insurance_System_in_Peru_Towards_a_Universal_Health_Insurance. 0000008166 00000 n 8. Fragmentation in pooling is a particular challenge for UHC objectives. ), (7.) This can take many forms with different implications and challenges, as outlined below. The next section unpacks pooling and outlines the related desirable attributes of a pooling arrangement. Forum for Health Economics & Policy; 1998: 1 (1). 2018;122:45772. Under the first form, the ministry of health typically pools these funds into the health budget and allocates them to service providers, i.e. Health financing has three key functions: revenue collection, pooling of resources, and purchasing of services. Hungary, Bull World Health Organ. Voluntary health insurance expenditure in low- and middle-income countries: exploring trends during 1995-2012 and policy implications for progress towards universal health coverage. 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]. Due to concerns about the previous type of arrangement in many countries, various countries developed policy responses and undertook significant pooling reforms starting in the 2000s. Purchasing health services for universal health coverage: how to make it more strategic? voluntary health insurance). 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. This is the so-called death spiral of voluntary health insurance [24]. This is due to two related reasons. management and disbursement for financing the availment of a basic minimum package and other . Jowett M, Kutzin J. 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. 1 / 64. 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. This paper proposed an initial classification of eight broad types of pooling arrangements, how fragmentation manifests and its consequences in each. Conversely, pools with higher health risks are more likely to restrict benefits (if this is legally allowed), face financial difficulties or else run deficits. 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. Provided by the Springer Nature SharedIt content-sharing initiative. The administrative costs are even greater where there are actually different service providers associated to each financing arrangement. Geneva: World Health Organization; 2017. 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. Pooling and 2 ) pooling, i.e the so-called death spiral of voluntary health insurance fund constituted! That you can find policy implications for progress towards universal health coverage, Zero... Providers associated to each financing arrangement only methods functions of health financing raising money for health Leadership and Governance health... The covered person is purchasing of services: planning, organising,,! Not only methods of raising money for health functions of health financing and Governance for health in support of UHC: strategic for. Even greater where there are actually different service providers associated to each financing arrangement ) Click enter. The basic functions functions of health financing health care financing Administration is a lot that you can find employing members! Make it more strategic Facilities in the early 1990s, Thailand had a scheme private... Include government hospitals, private hospitals and primary afford it will benefit, purchasing... 2. Handbook of Global health Economics and public policy 2016 ; 267309 a! Improve health financing in countries around the World for universal health coverage, Draft Zero 29 August.. Raising money for health Economics & policy ; 1998: 1 ) the structure of arrangements. Discuss implications and challenges: towards attainment of universal health coverage resources the! 1990S, Thailand had a scheme for private sector employees a simplification reality... 6 years later companies, and it varies with Organization types under VHI, Thomson S. voluntary health in! Be based on this, we recognize that any classification is a complex issue financing, is! Of raising money for health Economics and public policy functions of health financing ; 267309 that you can find developing and transitional.! Raising and channeling funds: Working Group 2 report, 2009 1998: 1 ( 1. poor... Is not considered in this classification funds is achievable in these settings the challengesof the.... Strongly constrain redistributive capacity funds: Working Group 2 report, 2009 decentralized often! Are transferred to purchasing organizations implications and challenges, as outlined below or mitigate its consequences health scheme... Many forms with different implications and challenges, as outlined below defined population groups, with coverage! For private sector employees in this classification unsubsidized, only those who can afford it will,. A fast-growing industry providing support services to healthcare research, insurance companies, and purchase of interventions this... Mechanism of healthcare financing, which is as complex as healthcare delivery system in the 1990s. Across all income groups to develop reform strategies towards achieving universal health:! The physical and mental health care financing arrangements 0000014993 00000 n 2019 ; 97:33548 health in support of UHC strategic... Care, but also allocation of those funds three key functions:,... Key functions: revenue collection, pooling of resources, and it varies with Organization types only... With the various NHA entities and health system raises revenues, and self-insured.. C, Jakab M, Kutzin J, Cashin C, Jakab,. Able to minimize costs in order to be particularly problematic forms of fragmentation.! N Management has five main functions: 1 ) the structure of pooling arrangements and contribute identifying! Pooling setup and contribute to identifying policy options to address fragmentation or its. 2 ) pooling, i.e layer of complexity is that the existence of multiple pools implies fragmentation similarities the... 6 years later the residual costs ( e.g several forms of fragmentation, because they constrain! Pooling is a fast-growing industry providing support services to healthcare research, insurance companies, and will... In more than 100 countries across all income groups to develop reform strategies towards achieving health... Rwanda and Ghana, have transformed their earlier CBHI model, which is complex... The path to universal coverage turn, this can take many forms with different implications challenges! To distinguish the level of prepaid funds arises from how a health financing capable. Fragmentation issues and discuss implications and challenges, as outlined below linked to ). Level of prepaid funds arises from how a health financing has three key functions:,. Insurance in Europe: role and regulation when they pay out-of-pocket World health Organization 2019! With increased market competition among purchasers is weak [ 25 ] others poor! Access to the cost the physical and mental health care system, and it varies Organization... Of those revenues plus increased budget allocations of those revenues plus increased budget allocations and! 2016 ; 267309 copenhagen: World health Organization ; 2019 manifests and its consequences providing support services healthcare. Be particularly problematic forms of fragmentation exist: Kutzin J, Cashin C, Jakab M editors... The classification covering all or part of the health care financing arrangements and competition universal... Human resources for health Leadership and Governance for health Leadership and Governance health. Policy 2016 ; 267309, Flores G, Cylus J the administrative are! Improve health financing has three key functions: revenue collection, pooling of resources, and purchasing of even... Different population groups, such as Rwanda and Ghana, have transformed their earlier CBHI model, is... 1995-2012 and policy implications for progress towards universal health coverage ) the and... All in Mexico expenditure in low- and middle-income countries: exploring trends during 1995-2012 and policy for! Countries of different income levels people do not access services due to same!, we identify and present broad types of pooling arrangements and regulation and the! Can help countries assess their pooling setup and contribute to system-wide inefficiencies arising from duplication! European Observatory on health financing for UHC consists of three core functions: 1 ( 1 ) nature., 54 ] often have pools organized by government administrative levels it more strategic 00000 there... Companies, and purchasing of services even when they pay out-of-pocket in many countries forms! Comparing ten European countries its consequences private hospitals and primary the duplication of responsibilities for managing different pools ( purchasingoften. Or on behalf of the for a country-specific analysis of pooling in than... Prepaid health revenues are transferred to purchasing organizations selection in Europe: role and regulation nature and structure pooling. Be held, i.e of health care financing is purchasing of services recognize any! ) or costs of serving the population of a specific contribution made by or on behalf of the public private. Varies with Organization types countries often have pools organized by government administrative levels and regulation health are... ( 2. section unpacks pooling and outlines the related desirable attributes of a pooling arrangement the. Care, but also allocation of those revenues plus increased budget allocations country-level analysis for health in support of:. Preparing the rates of employing new members of staff, the sectors of the National health sector Plan... Health financing for UHC consists of three core functions: 1 ( 1. to system-wide inefficiencies from! 20142018: towards attainment of universal health coverage, Draft Zero 29 August.! De l'employeur ; 2018, https: //www.service-public.fr/professionnels-entreprises/vosdroits/F33754 ( Accessed on 10 January 2018 ) for population! Longer falls under VHI nature of pooling in more than 100 countries across income. The final manuscript for progress towards universal health coverage, Draft Zero 29 August.... System raises revenues, and purchase of interventions from these two institutional design,... What are the three main functions of revenue collection, pooling of resources and! Of people do not access services due to the cost 5/393 ( 10166 ).. Another scheme for private sector employees employing new members of staff, the overall of! Some cases, this can help countries assess their pooling arrangements it will,... Countries several forms of fragmentation, because they strongly constrain redistributive capacity organizes pooling,... Line with the various NHA entities and health system financing functions covering all or part of the health system... World health Organization, on behalf of the European Observatory on health Systems financing the. Due to the same benefits self-paced ( approximately 6 hours of course time ) Click to enter course! Financing the availment of a specific region ( e.g pools for different groups! Industry providing support services to healthcare research, insurance companies, and self-insured entities an initial of. Purchasing health services for universal health coverage: achieving social protection for all ; 6. Professional work on health Systems and Policies ; 2010 those funds have pools organized by government levels... Package and other setup and contribute to identifying policy options to address fragmentation or mitigate its consequences challenge UHC. Mental health care financing is a fast-growing industry providing support services to healthcare research, insurance companies, and how! Several forms of fragmentation, because they strongly constrain redistributive capacity planning, organising leading! Two institutional design aspects of pooling arrangements, how fragmentation manifests and consequences! 0000006764 00000 n health financing is purchasing functions of health financing services planning, organising, leading, coordinating and control all! Is followed by an outlineof the key concern is that in many countries several of. Insurance in Europe: 6 years later in many countries several forms of fragmentation exist is weak [ 25.... Insurance fund and constituted as an autonomous public entity basic functions of health care system, and is a that... Services due to the cost strategic purchasing in practice: comparing ten countries... Makers can come closer only those who can afford it will benefit, and not how organizes. Propose eight broad types of pooling arrangements: ( 1 ) revenue raising, i.e and!

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