Caveat RAPtor : Regulation in Resource Allocation and Purchasing

This paper examines the effect that existing and proposed laws and regulations can have on the feasibility and effectiveness of arrangements for resource allocation and purchasing for the health sector in developing and transitional economies. The...

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Bibliographic Details
Main Author:	Feeley, Frank G.
Format:	Working Paper
Language:	English en_US
Published:	World Bank, Washington. DC 2013
Subjects:	ABILITY TO PAY ACCIDENTS ALCOHOL BEDS CAPITATION CHECKLIST CITIES CLINICS COMMUNITIES COMMUNITY HEALTH CREAM SKIMMING DISCRIMINATION DOCTORS EXTERNALITIES FAMILIES FAMILY PLANNING FINANCIAL RISK GENERAL PRACTITIONERS HEALTH CARE HEALTH CARE COSTS HEALTH CARE EXPENDITURES HEALTH CARE FINANCING HEALTH CARE SERVICES HEALTH CARE SPENDING HEALTH FINANCING HEALTH INSURANCE HEALTH MAINTENANCE ORGANIZATIONS HEALTH PROVIDERS HEALTH SECTOR HEALTH SERVICES HEALTH SYSTEM HMOS HOSPITAL BEDS HOSPITAL COSTS HOSPITALIZATION HOSPITALS HUMAN DEVELOPMENT HUMAN RESOURCES INCOME INFECTIOUS DISEASES INFERTILITY INJURY INNOVATION INSURANCE COMPANIES INSURANCE CONTRACTS INSURERS JURISDICTIONS LAWS LESSONS LEARNED LOW INCOME LOW-INCOME COUNTRIES MANAGED CARE MANAGED COMPETITION MARGINAL COST MARKETING MEDICAL ASSOCIATIONS MEDICAL BENEFITS MEDICAL CARE MEDICAL COSTS MEDICAL EQUIPMENT MEDICAL RECORDS MEDICAL TREATMENT MINISTRIES OF HEALTH NATIONAL HEALTH INSURANCE NEGOTIATIONS NUTRITION PATIENT CONFIDENTIALITY PATIENT EDUCATION PATIENT INFORMATION PATIENTS PHYSICIANS PRIMARY CARE PROMOTING HEALTH PROVIDER INCENTIVES PSYCHIATRISTS PSYCHIATRY PSYCHOLOGISTS PSYCHOTHERAPY PUBLIC HEALTH PUBLIC HEALTH CARE PUBLIC SECTOR PUBLIC SPENDING QUALITY OF CARE REGULATORY FRAMEWORK RESOURCE ALLOCATION SAFETY SANCTIONS SERVICE DELIVERY SOCIAL INSURANCE SOCIAL WORKERS TUBERCULOSIS VACCINATIONS purchasing RAP
Online Access:	http://documents.worldbank.org/curated/en/2004/09/5654881/caveat-raptor-regulation-resource-allocation-purchasing http://hdl.handle.net/10986/13707

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Summary:	This paper examines the effect that existing and proposed laws and regulations can have on the feasibility and effectiveness of arrangements for resource allocation and purchasing for the health sector in developing and transitional economies. The paper reviews effects of laws and regulations on: the medical benefits purchased, .the choice of medical provider, and .the transaction in which care is provided. Specific reference is made to recent experience in Russia, South Africa, Chile, and the Philippines, as well as possible precedents from more developed countries. Categories of law and regulation discussed include: provider licensing, monopoly and competition legislation, liability for professional negligence, mandated benefits and permitted exclusions, antidiscrimination laws, appeals procedures and other methods of asserting patient entitlement, rate setting and prohibitions on unauthorized provider charges, capacity controls and purchaser discretion in selecting providers, and patient confidentiality and collection of payment-related data.

Caveat RAPtor : Regulation in Resource Allocation and Purchasing

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