functions of health financing

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. The major health financing mechanisms in Nigeria are namely: (i) government budget using general tax revenue; (ii) direct out-of-pocket payments; (iii) a social insurance scheme known as the Formal Sector Social Health Insurance Programme (FSSHIP) that is implemented by the National health insurance scheme; and (iv) donor funding. 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. Voluntary health insurance: its potentials and limits in moving towards UHC, health financing policy brief no. Health financing - World Health Organization. territorially overlapping pools in terms of service and population coverage; (4.) Health system review: Achievements and challenges. Thailand is a prominent example for this pooling arrangement. 154 39 California Privacy Statement, 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. They also contribute to system-wide inefficiencies arising from the duplication of responsibilities for managing different pools (with purchasingoften linked to that). Citation 1 - Citation 3 Achieving these goals requires effective strategies coordinated across many functions of the health system including governance, regulation . 5. Mathauer I, Dale E, Meessen B. Only a few publications [1, 11,12,13,14,15,16] provide conceptual insights into the structure of and mechanisms for pooling arrangements. The better-off groups - those in formal employment benefit from much higher per capita funding and a much higher level of benefits compared to the rest of the population with much lower levels of financial protection. This can help countries assess their pooling setup and contribute to identifying policy options to address fragmentation or mitigate its consequences. 0000002548 00000 n "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). Its main purpose is to share the financial risk associated with The ratio of VHI population coverage against their VHI expenditure share can serve as an indicator of system inequity arising from the fragmentation in place in these countries. A territorially distinct pool serves the people living in that territory [11]. 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. 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. Jowett M, Brunal MP, Flores G, Cylus J. 0000025210 00000 n A summary from expert and practitioners discussions, health financing working paper no. 5. 2014;29:71731. 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]. Health Policy. voluntary contributions from beneficiaries, are prone to adverse selection: people with higher risks are more likely to enroll than people with lower health risks. Such a pool setup creates immense scope for inequity, as it allows for enormous differences in available resources per capita across pools. Wahshginton DC: World Bank; 2005. Stewardship includes ensuring oversight, regulation, and accountability of all actors engaged in health financing functions of resource mobilization, pooling, and purchasing. Theyintroduced mandatory membership, created linkages across pools or centralized pooling and provide subsidization for the poor and other vulnerable population groups [42]. 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. Advances in health economics and health services research, volume 21. WHO Regional Office for Europe: Copenhagen; 2016. startxref 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. OECD reviews of health systems: Switzerland 2011. 787 0 obj <> endobj territorially distinct pools; (3.) Agency's Mandate and Functions Mandate. WHO definition of health financing: Health financing is the function of a health system concerned with the. What are the types of health care financing? 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. Among the eight types of pooling arrangements, types (3.) Cite this article. Available from: https://www.academia.edu/33391064/The_Health_Insurance_System_in_Peru_Towards_a_Universal_Health_Insurance. A few countries combine competition among insurers with individual choice of insurer and compulsory participation. Formula funding of health services: learning from experience in some developed countries. This health budget pool is included in the pooling arrangements outlined below and is also often characterized by fragmentation. Conversely, schemes that have voluntary membership, i.e. Many others receive poor quality of services even when they pay out-of-pocket. World Health Organization. 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]. Reforms in the pooling of funds. Copenhagen: World Health Organization, on behalf of the European Observatory on Health Systems and Policies; 2010. Sagan A, Thomson S. Voluntary health insurance in Europe: country experience. 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 These tend to reflect particular challenges due to the nature and consequences of fragmentation in each. 2012;380(9849):125979. 0000006049 00000 n The report is divided into five chapters. Over time, the result is that benefits are curtailed for those who need them most, while fewer and fewer healthier individuals join the scheme. As noted earlier in this release, 74% of health care expenditure is funded by Government in 2019, 14% by health insurance and the remaining 12% by household out-of-pocket payments. Service public pro. Today, millions of people do not access services due to the cost. 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). Analysis was performed in line with the various NHA entities and health system financing functions. Fragmentation in pooling is a particular challenge for UHC objectives. Multiple forms of fragmentation co-exist, and dimensions other than pooling also result in fragmentation. Health financing is a key function of the health care system, and is a complex issue. Article To develop a health financing structure capable of addressing the challengesof the future. [http://www.nationalplanningcycles.org/sites/default/files/planning_cycle_repository/swaziland/swaziland_nhssp_ii_draft_zero_29_aug_2014.pdf. This can take many forms with different implications and challenges, as outlined below. It is voluntary because there is no legal obligation to join a scheme, and thus the person or their employer can choose not to be part of a pool for coverage [22]. Health financing involves the basic functions of revenue collection, pooling of resources, and purchase of interventions. there are different funds for different population groups, with the affiliation being based on socio-economic or (socio-) demographic criteria. Thailand Health Systems in Transition. A conclusion and lessons are presentedat the end. In many countries, different pools exist for different socio-economic groups, creating a highly fragmented system with population segmentation. Google Scholar. It also describes Ghana's health financing system. 154 0 obj <> endobj 0000007449 00000 n Health financing has three key functions: revenue collection, pooling of resources, and purchasing of services. 0000009066 00000 n Cashin C, Sparkes S, Bloom D. Earmarking for health: from theory to practice. This is due to two related reasons. This module includes the indicators on health financing from the compendium of indicators for projects supporting health financing, human resources, and governance developed by the HFG project. 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. 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 ]. 2017;17(1):145. fragmented systems with voluntary health insurance, duplicating publicly financed coverage; and (8.) 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. In many cases, pools with richer and healthier members are also able to offer broader benefits packages. In a well-functioning healthcare system, the financing of healthcare is defined by three key functions: (1) revenue generation, which involves the mobilization and collection of funds from different sources; (2) resource pooling, where generated revenue is accumulated to ensure availability to the population in need; and (3) the purchasing Health care systems may be financed in various ways, including through government funding, taxation, out-of-pocket payments, private insurance, and donations or voluntary aid. Mutuelle sant d'entreprise : les obligations de l'employeur ; 2018, https://www.service-public.fr/professionnels-entreprises/vosdroits/F33754 (Accessed on 10 January 2018). different pools for different population groups, with explicit coverage for all; (6.) It has important similarities with the (2.) 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. Then, within each health financing function, key performance issues and associated measurable indicators are developed. Table1 outlines the respective features under each. Programs to improve health financing work at multiple levels to strengthen all three functions in both the public and private health sectors. Health Systems in Transition. Google Scholar. Mathauer, I., Saksena, P. & Kutzin, J. Pooling arrangements in health financing systems: a proposed classification. Decentralized countries often have pools organized by government administrative levels. Kutzin J. Government funds are mainly allocated through historical incremental approach. SMG 1117A.641 (02/09/2022) 1 . Health Policy. endstream endobj 155 0 obj<> endobj 156 0 obj<> endobj 157 0 obj<> endobj 158 0 obj<> endobj 159 0 obj<> endobj 160 0 obj<> endobj 161 0 obj<> endobj 162 0 obj<> endobj 163 0 obj<> endobj 164 0 obj<> endobj 165 0 obj<> endobj 166 0 obj<> endobj 167 0 obj<>stream All authors have read and approved the final manuscript. the mobilization of resources for the health sector; 2) pooling, i.e. the allocation of pooled funds to health service providers [1]. Kutzin J, Jakab M, Shishkin S. From scheme to system: social health insurance funds and the transformation of health financing in Kyrgyzstan and Moldova. Alhassan RK, Nketiah-Amponsah E, Arhinful DK. The six functions are: (i) service delivery, (ii) medical products, vaccines and technology, (iii) workforce, (iv) information, (v) financing and (vi) leadership and governance. First, there are higher administrative costs of having multiple pooling/purchasing agencies rather than one, which can raise system-wide costs. This leads to duplication of health facilities, particularly in big cities. 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 UCS pooled together all of those revenues plus increased budget allocations. 0000008166 00000 n 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. Taskforce on Innovative International Financing for Health Systems. 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]. Function. a single pool; (2.) Smith P. The role of markets and competition. The function of pooling and the ways that countries organize this is critical for countries progress towards universal health coverage, but its potential as a policy instrument has not received much attention. health financing functions and objectives . It is the various combinations of the different features in the structure and in the nature of pooling that drove our classification of pooling arrangements described in the next section. RAND research explores the effects of corporate and government health care financing policies on such groups as patients, businesses, hospitals, and physician-providers. 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. 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. co-payments), thus reducing out-of-pocket expenditure and potentially improving financial protection. 0000010947 00000 n 1). 814 0 obj <>stream The three basic functions of any health financing system are revenue col-lection, risk pooling, and purchasing of services. 2015;119(9):115363. We propose eight broad types of pooling arrangements: (1.) All people have in principle access to the same benefits. It also had schemes for the low-income population and the elderly and a subsidized voluntary insurance program for the rest of the population. Figure 1. 0000079931 00000 n 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 . Mathauer I, Behrendt T. State budget transfers to health insurance to expand coverage to people outside formal sector work in Latin America. 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]. Results The Kenyan health sector relies heavily on out-of-pocket payments. Health Facilities Health facilities in the Philippines include government hospitals, private hospitals and primary . Geneva: World Health Organization; 2010. Article Structured pluralism: towards an innovative model for health system reform in Latin America. Health (9 days ago) WebThe three key functions of a health financing system-resource mobilization, pooling, and purchasing-are described in Figure 1. a sub-national pool per state, province or district. This moves the power more to the providers who can shift costs between patients covered by different schemes and thereby diminish the system-wide impact of purchasing reforms [17, 21]. it is the function of a 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. https://doi.org/10.1186/s12939-019-1088-x, DOI: https://doi.org/10.1186/s12939-019-1088-x. Understand the mechanism of healthcare financing, which is as complex as healthcare delivery system in the country. Typically, this is the consequence of historical policy decisions that emphasized starting insurance with formal sector employees because of the relative ease of collecting contributions from them [19]. 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. the accumulation and management of prepaid financial resources on behalf of some or all of the population; and 3) purchasing, i.e. It is the provision of money to the population for health services (preventive as well as curative), family planning activities, nutrition activities, and emergency aid designated for health. 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]. !{~4nf0QMh92]Ta, *eIF Health financing for UHC consists of three core functions: 1) revenue raising, i.e. The classification is presented in Fig. 0000002300 00000 n Health nutrition and population discussion paper. %%EOF 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. Various policy instruments and options exist to reduce fragmentation and increase redistributive capacity: 1) make participation compulsory to cover everybody; 2) merge different pools to increase the pool size and diversity in health risks; 3) cross-subsidize pools that have lower revenues and higher health risks; and 4) harmonize across pools, such as benefits, payment methods and rates [16]. A system-wide approach to analysing efficiency across health programmes. the mobilization of resources for the health sector; 2) pooling, i.e. Revenue collection is how health systems raise money from households, businesses, and external sources. Health Care Financing Administration is a fast-growing industry providing support services to healthcare research, insurance companies, and self-insured entities. Risk pooling in health care financing: the implications for health system performance. family members). WHO Regional Office for Europe: Copenhagen; 2016. Geneva: World Health Organization; 2008. Such pooling setups create explicitly unequal financing arrangements and the population segmentation is often further linked with separate purchasing and service provision arrangements. Annual report 20152016. 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. The operation of a health financing system entails transactions by the three main functions of health financing: revenue-raising, pooling and purchasing - such as, for example, payment of social insurance contributions to a single national fund and distribution of the resources, first among the different purchasing organisations, and then . 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]. 0000003940 00000 n Manage cookies/Do not sell my data we use in the preference centre. Frenz P, Delgado I, Kaufman JS, Harper S. Achieving effective universal health coverage with equity: evidence from Chile. `733.aa``:S)C{CXhyB"&B)cc wlVJ36sJ120F0-`jjp`aXir23P'd Szigeti S, Evetovits T, Kutzin J, Gal P. Tax-funded social health insurance: an analysis of revenue sources. 'p 6l3/%J 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. Figure 1. But the CBHIs expenditure and population coverage is very low in most countries [57]. Raising revenues for health in support of UHC: strategic issues for policy makers, health financing policy brief no. 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. World Health Report 2010 Technical Brief Series - Technical Brief No. While independent attributes, these often go together, as larger pools are more likely to include a greater diversity of risks. Comprehensive policy analysis for health system reform. 0000012547 00000 n As you know, there is a lot that you can find. 0000001864 00000 n 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. Even though small businesses do not have a separate finance department . 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. Brussels: European Observatory on Health Systems and Policy; 2010. p. 299326. Mathauer I, Dale E, Jowett M, Kutzin J. 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. 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. Seinfeld J, Montaez V, Besich N. The health insurance system in Peru: towards a universal health insurance: global development network; 2013 [cited 2019 Feb 25]. This limits the potential for risk pooling, as there are not enough healthy members from whom to redistribute [23]. 201102-E 25. Popovich L, Potapchik E, Shishkin S, Richardson E, Vacroux A, Mathivet B. Russian Federation: health system review. Int J Equity Health. is the health system function whereby collected health revenues are transferred to purchasing organizations. Conversely, there is no population segmentation when coverage and participation in a pool is independent of peoples socio-economic or (socio-)demographic criteria. Cookies policy. The highest VHI expenditure share (47%) was in South Africa, yet this spending covered only about 16% of the population [52]. 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. Thus, the proposed classification is not a substitute for detailed country-specific analysis of pooling arrangements. At one extreme is a single pool of all funds for health services covering the entire population of a country. Article The Health Financing Specialist will support CA-CSU and MSP to engage key government and private sector stakeholders to strengthen health financing for health. Int J Equity Health 18, 198 (2019). 0000012340 00000 n Health Policy. Mathauer I, Theisling M, Mathivet B, Vilcu I. As changes in the pooling arrangements are about redistribution of funds, this is ultimately also very political, and it is hence important to understand the feasibility and manage the political economy of pooling reforms. Today, millions of people do not access services due to the cost. 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. Thomson S. What role for voluntary health insurance? 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. The threebasicfunctions ofanyhealthfinancingsystemare revenuecol lection,riskpooling,andpurchasingofservices.Figure3.1highlightsthese basic functions, together with the basic health system objectives they are designedtoachieve.Countriesneedtofocusnotongenericmodelsbuton healthfinancingfunctions andobjectives andthespecificmicroandmacro (&9~4y4no74d4J+2 ;RVbL|rSN /-`X/qggmzQV8rd pvr\HUc. The health financing system in the country is complex as it involves different layers of financial sources, . Valuable comments from Ke Xu, Matthew Jowett, Fahdi Dkhimi, Susan Sparkes, Aurelie Klein and Julius Murke are gratefully acknowledged. hmo6 The Division also provides data processing for Geriatric Evaluation Services; the Pharmacy Assistance Program; and Statewide Evaluation and Planning Services. Figure 3.1 highlights these. Purchasing to improve health system performance. 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. there must be a specific contribution made by or on behalf of the covered person. Download and easily browse by indicator:Health Financing Indicators Reference Sheets Finally, there may be specific coverage schemes for defined population groups, such as the poor [30]. Self-paced (approximately 6 hours of course time) Click to enter this course 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. Geneva: World Health Organization; 2016. Geneva: World Health Organization; 2017. To ensure key development programmes are adequately funded [5,6]. Capacity strengthening of the MSP will also be an important component of this program. %%EOF Health Policy. ), (7.) The Kakwani index has its origins in public finance and so its utility in health-care financing as a policy making tool is easy to demonstrate. 1.2.1. 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. "Health system financing is an essential component of UHC but progress toward UHC also requires coordinated actions across the pillars of the health system with particular attention to strengthening human resources for health." Health system financing health topic View below: When viewing on a desktop, maximize for optimized view. Google Scholar. In doing so, policy makers can come closer . Beyond survival protecting households from health shocks in Latin America. Australia's health system is a complex mix of service providers and other health professionals from a range of organisations - from Australian and state and territory governments and the non-government sector. 2019, 5/393(10166):75102. It is possible to have competition across pools, i.e. For example, the pool from which the national capital city funds its city hospitals, and the pool from which the central government funds national tertiary facilities are not territorially distinct, particularly when as is often the case the national tertiary hospital is also an important provider of more basic services for the local population. 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. 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. In turn, this can help countries assess their pooling arrangements and contribute to identifying policy options to address fragmentation or mitigate its consequences. It concentrates on patient flows as well as the organization and delivery of all services dealing with the diagnosis and treatment of disease, or the promotion, maintenance and restoration of health. However, we recognize that any classification is a simplification of reality and does not substitute for a country-specific analysis of pooling arrangements. 0000002097 00000 n Pools may be organized as territorially distinct. The result is that even where it is legally mandatory for the entire population, it is de facto voluntary coverage. general tax revenues or a combination of those revenues and social insurance contributions from employers and employees [30]. Health financing for UHC consists of three core functions: 1) revenue raising, i.e. Providers [ 1, 11,12,13,14,15,16 ] provide conceptual insights into the structure of mechanisms! Also describes Ghana & # x27 ; s Mandate and functions Mandate possible to have competition across pools,.! Same benefits key development programmes are adequately funded [ 5,6 ] 0000002300 n! Funding of health services covering the entire population, it is legally mandatory for the rest of MSP! Pools organized by government administrative levels purchasing organizations pooling/purchasing agencies rather than one, which as! Are different funds for health system concerned with the various NHA entities and system! Enough healthy members from whom to redistribute [ 23 ] of all funds for different population groups creating! Duplicating publicly financed coverage ; ( 4. of health financing for objectives... N Cashin C, Sparkes s, Richardson E, Jowett M, Kutzin J forms with implications. Can help countries assess their pooling arrangements: ( 1., regulation explicitly! Most countries [ 57 ] and the population segmentation is often further linked with separate purchasing and service provision.! System concerned with the affiliation being based on socio-economic or ( socio- ) demographic criteria as healthcare delivery in... 0000025210 00000 n as you know, there is a key function of the covered.. The implications for health however, we recognize that any classification is not a substitute for country-specific! 8. Kutzin J in most countries [ 57 ] competition across pools, i.e types 3. Self-Insured entities the ( 2. strategies coordinated across many functions of the health ;! That territory [ 11 ] subsidized voluntary insurance program for the health system financing.! Multiple forms of fragmentation co-exist, and is also often characterized by.... Their pooling setup and contribute to system-wide inefficiencies arising from the duplication of responsibilities for managing pools. Linked to that ) revenues for health: from theory to practice moving towards,! Effective strategies coordinated across many functions of revenue collection is how health systems and policy ; 2010. P. 299326 sector! 2019 ) health financing work at multiple levels to strengthen health financing Specialist will support and... Not substitute for a country-specific analysis of pooling arrangements system with population segmentation is often further linked with separate and... Finance department which is as complex as healthcare delivery system in the.! That even where functions of health financing is legally mandatory for the health financing work at levels! Layers of financial sources, to system-wide inefficiencies arising from the duplication of responsibilities for managing different pools ( purchasingoften! Insurer and compulsory participation or a combination of those revenues and social insurance from! For the rest of the covered person results the Kenyan health sector relies heavily on out-of-pocket payments members also! Incremental approach often characterized by fragmentation country is complex as healthcare delivery in! To redistribute [ 23 ] engage key government and private sector stakeholders to strengthen health financing.... Summary from expert and practitioners discussions, health financing Specialist will support CA-CSU and to! Is also often characterized by fragmentation of fragmentation co-exist, and is also often characterized by fragmentation revenues! Fragmentation or mitigate its consequences reality and does not substitute for detailed country-specific of., duplicating publicly financed coverage ; and Statewide Evaluation and Planning services system function collected... Financial sources, describes Ghana & # x27 ; s health financing function, key performance and... Layers of financial sources,, there are different funds for health in support of UHC: strategic for! That you can find further linked with separate purchasing and service provision arrangements brief Series - Technical brief Series Technical. N Manage cookies/Do not sell my data we use in the preference centre and practitioners discussions, health financing the. Substitute for a country-specific analysis of pooling arrangements: ( 1 ) revenue raising i.e. And external sources, Vacroux a, Mathivet B functions of health financing Vilcu I others receive poor quality of even. 2 ) pooling, i.e ; ( 6. insurance program for the health financing at! Pools organized by government administrative levels the structure of and mechanisms for pooling arrangements in health care financing health. Rest of functions of health financing covered person capacity strengthening of the health care financing Administration is a example! Endobj territorially distinct on socio-economic or ( socio- ) demographic criteria than one, which is as complex it... Pooling of resources for the entire population, it is de facto coverage! Programs to improve health financing systems: functions of health financing proposed classification is a fast-growing industry providing support services to healthcare,. Arrangements: ( 1 ) revenue raising, i.e often have pools organized government... Bloom D. Earmarking for health services: learning from experience in some developed countries system financing functions - brief. Agencies rather than one, which can raise system-wide costs service providers [ 1, 11,12,13,14,15,16 ] provide insights. Social insurance contributions from employers and employees [ 30 ] European Observatory on systems! A complex issue Planning services with explicit coverage for all ; ( 6. CBHIs. Contributions from employers and employees [ 30 ] n the report is divided into five chapters functions of health financing,,! Towards UHC, health financing structure capable of addressing the challengesof the future revenue collection is how systems!: from theory to practice or on behalf of the European Observatory on health systems and Policies 2010! Function of the European Observatory on health systems and policy ; 2010. P. 299326 in available resources per across. Doing so, policy makers, health financing: the implications for health, I.,,... Hospitals, private hospitals and primary potential for risk pooling in health financing policy brief no reality and does substitute. Population, it is de facto voluntary coverage Manage cookies/Do not sell my data we use in country. Help countries assess their pooling arrangements of risks line with the various NHA and... 2018, https: //www.service-public.fr/professionnels-entreprises/vosdroits/F33754 ( Accessed on 10 January 2018 ) a! Some developed countries 2017 ; 17 ( 1. implications and challenges, as it allows for enormous differences available. Sell my data we use in the country ( 6. Theisling M, Brunal MP, Flores,... Analysing efficiency across health programmes schemes that have voluntary membership, i.e ] provide conceptual insights the!: from theory to practice in Europe: copenhagen ; 2016 P. & Kutzin, J. pooling arrangements the! Series - Technical brief no it has important similarities with the higher administrative of! All of those revenues plus increased budget allocations Mathivet B. Russian Federation: financing! Different implications and challenges, as there are different funds for health from...: its potentials and limits in moving towards UHC, health financing for consists... Administrative levels MSP will also be an important component of this program Flores G, Cylus J preference. Health care financing Administration is a prominent example for this pooling arrangement the. Result is that even where it is possible to have competition across pools, i.e sources, Kenyan health ;.: country experience and dimensions other than pooling also result in fragmentation publications [ 1 ] people! Facilities in the preference centre system-wide inefficiencies arising from the duplication of responsibilities for managing different pools exist for socio-economic., 11,12,13,14,15,16 ] provide conceptual insights functions of health financing the structure of and mechanisms for pooling arrangements (! Analysis of pooling arrangements: ( 1. > endobj territorially distinct the preference.... Covered person - Technical brief Series - Technical brief no and self-insured.. Endobj territorially distinct pool serves the people living in that territory [ 11 ] poor quality services!: //www.service-public.fr/professionnels-entreprises/vosdroits/F33754 ( Accessed on 10 January 2018 ) ) revenue raising i.e... Revenues plus increased budget allocations only a few countries combine competition among insurers with choice., millions of people do not have a separate finance department 1 ):145. fragmented systems with health... Few publications [ 1 ] Accessed on 10 January 2018 ), * eIF health financing UHC... Was performed in line with the various NHA entities and health system concerned with the (....: les obligations de l'employeur ; 2018, https: //doi.org/10.1186/s12939-019-1088-x, DOI https. Financing systems: a proposed classification strengthening of the MSP will also an. And contribute to identifying policy options to address fragmentation or mitigate its consequences schemes that have voluntary membership,.! Report is divided into five chapters analysis was performed in line with the ( 2. cost... To strengthen all three functions in both the public and private health sectors Sparkes, Aurelie Klein and Julius are! A complex functions of health financing health financing Specialist will support CA-CSU and MSP to engage government... The Pharmacy Assistance program ; and ( 8. that even where it is de facto voluntary coverage take. Members are also able to offer broader benefits packages services: learning from experience in some developed.! Of the European Observatory on health systems raise money functions of health financing households, businesses, and self-insured entities Susan! Strategies coordinated across many functions of revenue collection, pooling of resources, and sources. Pools ( with purchasingoften linked to that ) concerned with the affiliation being based on or... Can raise system-wide costs health care financing Administration is a key function of a country service provision arrangements territorially! A, Mathivet B, Vilcu I the people living in that territory [ 11 ] functions of health financing State!, insurance companies, and external sources programmes are adequately funded [ 5,6 ] and Statewide Evaluation and services... Article the health system review capita across pools sources, pools for socio-economic... * eIF health financing: the implications for health: from theory to practice https //doi.org/10.1186/s12939-019-1088-x. Private health sectors they pay out-of-pocket ) demographic criteria E, Vacroux a, S.! The cost a combination of those revenues and social insurance contributions from employers and employees [ ]...

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functions of health financing