Assessment of Systems for Paying Health Care Providers in Mongolia : Implications for Equity, Efficiency and Universal Health Coverage
Achieving access to basic health services for the entire population without risk of financial hardship or impoverishment from out-of-pocket expenditures (‘universal health coverage’ or UHC) is a challenge that continues to confront most low- and mi...
| Main Authors: | , , , |
|---|---|
| Language: | English en_US |
| Published: |
World Bank, Washington, DC
2015
|
| Subjects: | |
| Online Access: | http://documents.worldbank.org/curated/en/2015/08/24932894/assessment-systems-paying-health-care-providers-mongolia-implications-equity-efficiency-universal-health-coverage http://hdl.handle.net/10986/22812 |
| Summary: | Achieving access to basic health
services for the entire population without risk of financial
hardship or impoverishment from out-of-pocket expenditures
(‘universal health coverage’ or UHC) is a challenge that
continues to confront most low- and middle-income countries.
As coverage expands in these countries, issues of financial
sustainability, efficiency, and quality of care quickly rise
to the surface. Strategic health purchasing is an important
lever to efficiently manage funds for UHC through the
definition of what is purchased (which services and benefits
the covered population is entitled to receive), from whom
services are purchase (which providers are contracted to
deliver the covered services), and how and how much the
providers are paid. The assessment was conducted to help
inform the design and implementation of Mongolia’s provider
payment systems going forward. Health care provider payment
systems, the way providers are paid to deliver the covered
package of services, are an important part of strategic
purchasing to balance system revenues and costs in a way
that creates incentives for providers to improve quality and
deliver services more efficiently. This ultimately makes it
possible to expand coverage within limited funds
(Langenbrunner, Cashin and ODougherty 2009). In practice,
however, provider payment systems are often under-utilized
as an effective tool to achieve UHC goals. After providing a
brief overview of Mongolia’s health financing and service
delivery system, this report describes the provider payment
assessment and summarizes the main findings. It discusses
the positive aspects and shortcomings of the current mix of
payment systems and compares the design and implementation
with international good practices. The chapter concludes by
providing a roadmap for refining and realigning Mongolia’s
provider payment system going forward. |
|---|