Designing And Implementing Health Care Provider Payment Systems
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Designing And Implementing Health Care Provider Payment Systems
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Author : Jack Langenbrunner
language : en
Publisher: World Bank Publications
Release Date : 2009-01-01
Designing And Implementing Health Care Provider Payment Systems written by Jack Langenbrunner and has been published by World Bank Publications this book supported file pdf, txt, epub, kindle and other format this book has been release on 2009-01-01 with Medical categories.
Strategic purchasing of health services involves a continuous search for the best ways to maximize health system performance by deciding which interventions should be purchased, from whom these should be purchased, and how to pay for them. In such an arrangement, the passive cashier is replaced by an intelligent purchaser that can focus scarce resources on existing and emerging priorities rather than continuing entrenched historical spending patterns.Having experimented with different ways of paying providers of health care services, countries increasingly want to know not only what to do when paying providers, but also how to do it, particularly how to design, manage, and implement the transition from current to reformed systems. 'Designing and Implementing Health Care Provider Payment Systems: How-To Manuals' addresses this need.The book has chapters on three of the most effective provider payment systems: primary care per capita (capitation) payment, case-based hospital payment, and hospital global budgets. It also includes a primer on a second policy lever used by purchasers, namely, contracting. This primer can be especially useful with one provider payment method: hospital global budgets. The volume's final chapter provides an outline for designing, launching, and running a health management information system, as well as the necessary infrastructure for strategic purchasing.
Implementation Of Casemix System As Prospective Provider Payment Method In Social Health Insurance A Case Study Of Acheh Provincial Health Insurance
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Author : Prof Dr Syed Mohamed Aljunid
language : en
Publisher: Partridge Publishing Singapore
Release Date : 2022-11-20
Implementation Of Casemix System As Prospective Provider Payment Method In Social Health Insurance A Case Study Of Acheh Provincial Health Insurance written by Prof Dr Syed Mohamed Aljunid and has been published by Partridge Publishing Singapore this book supported file pdf, txt, epub, kindle and other format this book has been release on 2022-11-20 with Business & Economics categories.
The Government of Aceh Province in Indonesia has established the Social Health Insurance (SHI) called Jaminan Kesehatan Aceh (JKA) in 2006 that provide health coverage to all 4.6 million population of the province. Fee-for-service was initially used as the provider payment method in the programme until 2013. In 2014, in line with the National Health Insurance of Indonesia (Jaminan Kesehatan Nasional JKN), INA-CBG (Indonesia Case-Based Group) casemix system was adopted by JKA to replace the Fee-for-Service method. This book presents outcome of the evaluation done using a combination of qualitative and quantitative methods on the implementation of JKA programme. The quantitative study was conducted to assess income of three selected hospitals (Type B, C and D) reimbursed using INA-CBG groups covering more than 17,000 cases. Quantitative data analysis revealed that overall, the hospitals received 32.4% higher income when reimbursed with casemix system (INA-CBG) as compared to fee-for-service. Type D hospital is the biggest gainer with 81.0% increase in income. In conclusion, the use of Casemix (INA-CBG) as a prospective payment method has benefitted the hospitals a lot. It is hope that additional resources gained through this programme will allow the hospitals to provide optimum care to the population.
Implementing Health Sector Reform In Central Asia
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Author : Zuzana Feachem
language : en
Publisher: World Bank Publications
Release Date : 1999
Implementing Health Sector Reform In Central Asia written by Zuzana Feachem and has been published by World Bank Publications this book supported file pdf, txt, epub, kindle and other format this book has been release on 1999 with Medical categories.
It is easy for reformers and their overseas advisers to develop conceptually strong plans for health sector reform that appeal to governments, donors, and academics. Transforming these plans into successful action has proved to be extremely difficult. Toward the goal of improving assistance to this sector, the Economic Development Institute (EDI) of the World Bank held a seminar in Ashgabat, Turkmenistan in June 1996. This publication provides a summary of the proceedings and papers presented at that seminar. It was attended by delegations from five countries in Central Asia and from Azerbaijan and Mongolia. The content of this volume emphasizes topics central to the restructuring of health sector financing and health care delivery systems at a time of transition to market economies and to democracy. Maintaining and improving the health status of the population while preventing rapid escalation of health care expenditure were the recurrent themes throughout the seminar.
Operational Framework For Primary Health Care
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Author :
language : en
Publisher: World Health Organization
Release Date : 2020-12-16
Operational Framework For Primary Health Care written by and has been published by World Health Organization this book supported file pdf, txt, epub, kindle and other format this book has been release on 2020-12-16 with Medical categories.
Health Insurance Handbook
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Author : Hong Wang
language : en
Publisher: World Bank Publications
Release Date : 2012-01-18
Health Insurance Handbook written by Hong Wang and has been published by World Bank Publications this book supported file pdf, txt, epub, kindle and other format this book has been release on 2012-01-18 with Business & Economics categories.
Many countries that subscribe to the Millennium Development Goals (MDGs) have committed to ensuring access to basic health services for their citizens. Health insurance has been considered and promoted as the major financing mechanism to improve access to health services, as well to provide financial risk protection.
Fairness And Accountability
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Author : The World Bank
language : en
Publisher: World Bank Publications
Release Date : 2013
Fairness And Accountability written by The World Bank and has been published by World Bank Publications this book supported file pdf, txt, epub, kindle and other format this book has been release on 2013 with categories.
The new MENA health strategy for 2013-2018 is focused on the creation of “fair” and “accountable” health systems in the region. Conceived through a yearlong process, it captures the World Bank’s commitment to overarching principles in a sustainable manner. It first analyzes the status of health systems in the region; then describes how health care can be made more fair and accountable; next provides examples of World Bank global expertise and products to do so; and concludes with details of how the strategy will be implemented. Through this strategy, the World Bank is committed to supporting governments to implement their priorities in the health sector in order to create more fair and accountable systems for the people.
Transition To Diagnosis Related Group Drg Payments For Health
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Author : Caryn Bredenkamp
language : en
Publisher: World Bank Publications
Release Date : 2019-12-19
Transition To Diagnosis Related Group Drg Payments For Health written by Caryn Bredenkamp and has been published by World Bank Publications this book supported file pdf, txt, epub, kindle and other format this book has been release on 2019-12-19 with Medical categories.
This book examines how nine different health systems--U.S. Medicare, Australia, Thailand, Kyrgyz Republic, Germany, Estonia, Croatia, China (Beijing) and the Russian Federation--have transitioned to using case-based payments, and especially diagnosis-related groups (DRGs), as part of their provider payment mix for hospital care. It sheds light on why particular technical design choices were made, what enabling investments were pertinent, and what broader political and institutional issues needed to be considered. The strategies used to phase in DRG payment receive special attention. These nine systems have been selected because they represent a variety of different approaches and experiences in DRG transition. They include the innovators who pioneered DRG payment systems (namely the United States and Australia), mature systems (such as Thailand, Germany, and Estonia), and countries where DRG payments were only introduced within the past decade (such as the Russian Federation and China). Each system is examined in detail as a separate case study, with a synthesis distilling the cross-cutting lessons learned. This book should be helpful to those working on health systems that are considering introducing, or are in the early stages of introducing, DRG-based payments into their provider payment mix. It will enhance the reader's understanding of how other countries (or systems) have made that transition, give a sense of the decisions that lie ahead, and offer options that can be considered. It will also be useful to those working in health systems that already include DRG payments in the payment mix but have not yet achieved the anticipated results.
Universal Health Coverage
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Author : Aida Isabel Tavares
language : en
Publisher: BoD – Books on Demand
Release Date : 2019-11-27
Universal Health Coverage written by Aida Isabel Tavares and has been published by BoD – Books on Demand this book supported file pdf, txt, epub, kindle and other format this book has been release on 2019-11-27 with Medical categories.
The chapters in this book contribute to the wide discussion on universal health coverage. The variety of topics discussed here confirms the importance of UHC for academics and health professionals and also the controversies and challenges of its implementation.I invite you to read the book and be involved in the discussions around the goals of universal health coverage.
Diagnosis Related Groups
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Author :
language : en
Publisher: World Health Organization
Release Date : 2020-06-30
Diagnosis Related Groups written by and has been published by World Health Organization this book supported file pdf, txt, epub, kindle and other format this book has been release on 2020-06-30 with Law categories.
Health System Transformation In The Islamic Republic Of Iran
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Author : World Health Organization
language : en
Publisher: World Health Organization
Release Date : 2019-10-15
Health System Transformation In The Islamic Republic Of Iran written by World Health Organization and has been published by World Health Organization this book supported file pdf, txt, epub, kindle and other format this book has been release on 2019-10-15 with Medical categories.