Transcript Financing
Introduction to Flagship Courses on :
Health Sector Reform & Sustainable
Financing
&
Module 3 & 4:
Health System Financing
Provider Payment Systems
May 18-21, 2005
Khoramabad - Lorestan
Dr Kambiz Monazzam
Nature of the health Challenges
Demographic & epidemiologic changes
Increase Age of population
New diseases & return of some old diseases
Increasing health costs
New technologies
Changing lifestyle toward unsafe behavior
Change to high cost diseases
Health policy making is not evidence based
Unavailable/Inaccurate Data & Information
Inaccurate Decision Making process/Methodology
2
Nature of the health Challenges
Money-Problem (Budget-Disease burden)
Mismatch
Huge sums of money mismanaged
Health Sector Reform is complex
Limited Inter-country learning
Failure to complement advocacy about
“What to Do” with “How to Do it”.
3
History &
Background:
1993: World Bank Report
1996: first annual global core course at WB
1996-2002: Bank introduce global + regional
courses
80% of training now through 10 regional
partner institutes
2003-2004: IRAN Flagship Course
4
Objectives of Health Reform:
Improve health status of population
Improve consumer satisfaction
Assure financial protection
Enhance equity and access
Increase macroeconomic and
microeconomic efficiency
Strengthen clinical effectiveness
Improve quality of care
Other!?
Improve sustainability
Effect on employment
5
Operating Model
Africa Partners:
Senegal
Francophone
Network
Tanzania
Asia Partners:
China &
Thailand
Global
Core Courses
MENA Partners:
Lebanon & Iran
LAC Partners:
Chile & Mexico
ECA Partners:
Hungary &
Russia
Distance Learning & Knowledge Management
6
2003-2004: IRAN Flagship Course:
World Bank Institute
American University of Beirut
Harvard School of Public Health
MOH & ME of Iran
National Health Sector Reform Unit
7
Teaching Committee:
Paul Shaw
Daniel Kress
Mark Roberts
William Hsiao
George Scheiber
Miriam Wiley
Richardo Bitran
Alexander Preker
Mark Basset
Robert Creighton
Lim Meng Kin
Tom Bossert
1
1
2
3
4
4
5
6
6
6
6
6
Coordinators:
Dr Sima Ramadan
Dr Hadia Karam
8
What Does Flagship Mean?
The first or commander ship usually
with a flag on it
The best thing,
9
Objectives of Flagship course:
Reaching a method or approach to deal
with complex (but similar) health system
problems /finding solutions for them
Contributing to a ‘common language on
reform’ among client countries
Responding to changing demand such
as linking achieving the Millennium
Development Goals
10
Goals of Financing Module
Provide more in-depth knowledge of the
financing control knob
Study the five methods of financing and
compare their strengths and weaknesses
Provide tools—NHA and strategic
framework for national financing
Work through a financing strategy for Iran
11
Financing Affects What Goals?
Average and Distribution
Access to
health care
Health
Status
Quality of
Services
Prevention
Financing
Risk
Protection
Cost
Equity in distributing
costs and benefits
Public
Satisfaction
12
Goals of Payment Module
Provide more in-depth knowledge of the
payment control knob
Study methods of payment to providers in
both inpatient & outpatient services and
compare their strengths and weaknesses
Study effects of methods of payment on
financial risk burden & Provider incentives
Understand contracting tool / process
13
Payment Affects What Goals?
Average and Distribution
Access to
health care
Health
Status
Quality of
Services
Prevention
payment
Risk
Protection
Cost
Equity in distributing
costs and benefits
Public
Satisfaction
14