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...
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| Format: | Report |
| Language: | English en_US |
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World Bank, Washington, DC
2015
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| 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 |
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okr-10986-22812 |
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| recordtype |
oai_dc |
| repository_type |
Digital Repository |
| institution_category |
Foreign Institution |
| institution |
Digital Repositories |
| building |
World Bank Open Knowledge Repository |
| collection |
World Bank |
| language |
English en_US |
| topic |
HEALTH CARE PROVIDERS CHILD HEALTH CLINICAL GUIDELINES DEFICIT RISKS INSUFFICIENT FUNDING HEALTH SERVICE DELIVERY CHRONIC DISEASES VILLAGES PHYSICIAN RECEIVABLES FINANCING FINANCIAL MANAGEMENT VILLAGE DEATHS INCOME FEE FOR SERVICE PREVENTION DOCTORS SALARY MORBIDITY PAYMENT SYSTEM BASIC HEALTH SERVICES PRIMARY CARE HEALTH INSURANCE HEALTH CARE REVENUES INCENTIVES HEALTH SALARIES HEALTH PROFESSIONALS RECORD KEEPING FEE DIRECT PAYMENTS PARAMEDICS POOL OF FUNDS OWNERSHIP PAYMENTS HEALTH FACILITIES PUBLIC HEALTH FINANCIAL AUTONOMY BUDGET HOSPITALIZATION HEALTH SECTOR CAPITATION PHARMACIES CHOICE FINANCIAL SUSTAINABILITY COSTS PATIENTS PATIENT HARD BUDGET INTERVENTION PUBLIC FUNDS DEBTS HEALTH SYSTEMS PUBLIC HOSPITALS HEALTH CENTERS CASH PAYMENT LEVEL OF PAYMENT NURSES HEALTH MANAGEMENT HOSPITAL ADMISSIONS PAYMENT DEBT DEFICITS HEALTH ORGANIZATION HOSPITAL SERVICES MIGRANTS MORTALITY LEGAL FRAMEWORK FINANCE HEALTH PROMOTION EXPENDITURE MARKET ECONOMY FREE CHOICE GRANT EQUITY BUDGET CONSTRAINT COTS WORKERS CAPITAL SURGERY INCENTIVE SCHEMES CHRONIC DISEASE HEALTH DELIVERY USER FEES FAMILY CARE BANK FINANCIAL HARDSHIP BUDGETS DEMAND CLAIMS FINANCIAL DISCIPLINE EXPENDITURES INSURANCE AGENCY MANDATES TEACHING HOSPITALS ASSETS PAYMENT ARRANGEMENT COST PER CASE HEALTH CARE PROVIDER PRIMARY HEALTH CARE HEALTH SYSTEM INSURANCE WEIGHT PREGNANT WOMEN HEALTH CARE DELIVERY BUDGET DEFICITS HOSPITAL “DISTRICTS HUMAN RESOURCES PUBLIC FACILITIES HEALTH PROVIDERS POVERTY HEALTH EXPENDITURE ILLNESS PRIVATE PHARMACIES COOPERATION REHABILITATION POPULATION STRATEGY FEES REGISTRATION MEDICINES HEALTH FINANCING HOSPITALS PAYMENT SYSTEMS HEALTH CARE SYSTEMS HEALTH SERVICE RECURRENT COSTS HEALTH SERVICES IMPLEMENTATION EQUITABLE DISTRIBUTION PROVIDER PAYMENT |
| spellingShingle |
HEALTH CARE PROVIDERS CHILD HEALTH CLINICAL GUIDELINES DEFICIT RISKS INSUFFICIENT FUNDING HEALTH SERVICE DELIVERY CHRONIC DISEASES VILLAGES PHYSICIAN RECEIVABLES FINANCING FINANCIAL MANAGEMENT VILLAGE DEATHS INCOME FEE FOR SERVICE PREVENTION DOCTORS SALARY MORBIDITY PAYMENT SYSTEM BASIC HEALTH SERVICES PRIMARY CARE HEALTH INSURANCE HEALTH CARE REVENUES INCENTIVES HEALTH SALARIES HEALTH PROFESSIONALS RECORD KEEPING FEE DIRECT PAYMENTS PARAMEDICS POOL OF FUNDS OWNERSHIP PAYMENTS HEALTH FACILITIES PUBLIC HEALTH FINANCIAL AUTONOMY BUDGET HOSPITALIZATION HEALTH SECTOR CAPITATION PHARMACIES CHOICE FINANCIAL SUSTAINABILITY COSTS PATIENTS PATIENT HARD BUDGET INTERVENTION PUBLIC FUNDS DEBTS HEALTH SYSTEMS PUBLIC HOSPITALS HEALTH CENTERS CASH PAYMENT LEVEL OF PAYMENT NURSES HEALTH MANAGEMENT HOSPITAL ADMISSIONS PAYMENT DEBT DEFICITS HEALTH ORGANIZATION HOSPITAL SERVICES MIGRANTS MORTALITY LEGAL FRAMEWORK FINANCE HEALTH PROMOTION EXPENDITURE MARKET ECONOMY FREE CHOICE GRANT EQUITY BUDGET CONSTRAINT COTS WORKERS CAPITAL SURGERY INCENTIVE SCHEMES CHRONIC DISEASE HEALTH DELIVERY USER FEES FAMILY CARE BANK FINANCIAL HARDSHIP BUDGETS DEMAND CLAIMS FINANCIAL DISCIPLINE EXPENDITURES INSURANCE AGENCY MANDATES TEACHING HOSPITALS ASSETS PAYMENT ARRANGEMENT COST PER CASE HEALTH CARE PROVIDER PRIMARY HEALTH CARE HEALTH SYSTEM INSURANCE WEIGHT PREGNANT WOMEN HEALTH CARE DELIVERY BUDGET DEFICITS HOSPITAL “DISTRICTS HUMAN RESOURCES PUBLIC FACILITIES HEALTH PROVIDERS POVERTY HEALTH EXPENDITURE ILLNESS PRIVATE PHARMACIES COOPERATION REHABILITATION POPULATION STRATEGY FEES REGISTRATION MEDICINES HEALTH FINANCING HOSPITALS PAYMENT SYSTEMS HEALTH CARE SYSTEMS HEALTH SERVICE RECURRENT COSTS HEALTH SERVICES IMPLEMENTATION EQUITABLE DISTRIBUTION PROVIDER PAYMENT Joint Learning Network Mongolia Ministry of Health World Bank World Health Organization Assessment of Systems for Paying Health Care Providers in Mongolia : Implications for Equity, Efficiency and Universal Health Coverage |
| geographic_facet |
East Asia and Pacific Mongolia |
| description |
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. |
| format |
Report |
| author |
Joint Learning Network Mongolia Ministry of Health World Bank World Health Organization |
| author_facet |
Joint Learning Network Mongolia Ministry of Health World Bank World Health Organization |
| author_sort |
Joint Learning Network |
| title |
Assessment of Systems for Paying Health Care Providers in Mongolia : Implications for Equity, Efficiency and Universal Health Coverage |
| title_short |
Assessment of Systems for Paying Health Care Providers in Mongolia : Implications for Equity, Efficiency and Universal Health Coverage |
| title_full |
Assessment of Systems for Paying Health Care Providers in Mongolia : Implications for Equity, Efficiency and Universal Health Coverage |
| title_fullStr |
Assessment of Systems for Paying Health Care Providers in Mongolia : Implications for Equity, Efficiency and Universal Health Coverage |
| title_full_unstemmed |
Assessment of Systems for Paying Health Care Providers in Mongolia : Implications for Equity, Efficiency and Universal Health Coverage |
| title_sort |
assessment of systems for paying health care providers in mongolia : implications for equity, efficiency and universal health coverage |
| publisher |
World Bank, Washington, DC |
| publishDate |
2015 |
| url |
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 |
| _version_ |
1764451859327614976 |
| spelling |
okr-10986-228122021-04-23T14:04:10Z Assessment of Systems for Paying Health Care Providers in Mongolia : Implications for Equity, Efficiency and Universal Health Coverage Joint Learning Network Mongolia Ministry of Health World Bank World Health Organization HEALTH CARE PROVIDERS CHILD HEALTH CLINICAL GUIDELINES DEFICIT RISKS INSUFFICIENT FUNDING HEALTH SERVICE DELIVERY CHRONIC DISEASES VILLAGES PHYSICIAN RECEIVABLES FINANCING FINANCIAL MANAGEMENT VILLAGE DEATHS INCOME FEE FOR SERVICE PREVENTION DOCTORS SALARY MORBIDITY PAYMENT SYSTEM BASIC HEALTH SERVICES PRIMARY CARE HEALTH INSURANCE HEALTH CARE REVENUES INCENTIVES HEALTH SALARIES HEALTH PROFESSIONALS RECORD KEEPING FEE DIRECT PAYMENTS PARAMEDICS POOL OF FUNDS OWNERSHIP PAYMENTS HEALTH FACILITIES PUBLIC HEALTH FINANCIAL AUTONOMY BUDGET HOSPITALIZATION HEALTH SECTOR CAPITATION PHARMACIES CHOICE FINANCIAL SUSTAINABILITY COSTS PATIENTS PATIENT HARD BUDGET INTERVENTION PUBLIC FUNDS DEBTS HEALTH SYSTEMS PUBLIC HOSPITALS HEALTH CENTERS CASH PAYMENT LEVEL OF PAYMENT NURSES HEALTH MANAGEMENT HOSPITAL ADMISSIONS PAYMENT DEBT DEFICITS HEALTH ORGANIZATION HOSPITAL SERVICES MIGRANTS MORTALITY LEGAL FRAMEWORK FINANCE HEALTH PROMOTION EXPENDITURE MARKET ECONOMY FREE CHOICE GRANT EQUITY BUDGET CONSTRAINT COTS WORKERS CAPITAL SURGERY INCENTIVE SCHEMES CHRONIC DISEASE HEALTH DELIVERY USER FEES FAMILY CARE BANK FINANCIAL HARDSHIP BUDGETS DEMAND CLAIMS FINANCIAL DISCIPLINE EXPENDITURES INSURANCE AGENCY MANDATES TEACHING HOSPITALS ASSETS PAYMENT ARRANGEMENT COST PER CASE HEALTH CARE PROVIDER PRIMARY HEALTH CARE HEALTH SYSTEM INSURANCE WEIGHT PREGNANT WOMEN HEALTH CARE DELIVERY BUDGET DEFICITS HOSPITAL “DISTRICTS HUMAN RESOURCES PUBLIC FACILITIES HEALTH PROVIDERS POVERTY HEALTH EXPENDITURE ILLNESS PRIVATE PHARMACIES COOPERATION REHABILITATION POPULATION STRATEGY FEES REGISTRATION MEDICINES HEALTH FINANCING HOSPITALS PAYMENT SYSTEMS HEALTH CARE SYSTEMS HEALTH SERVICE RECURRENT COSTS HEALTH SERVICES IMPLEMENTATION EQUITABLE DISTRIBUTION PROVIDER PAYMENT 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. 2015-11-03T16:26:09Z 2015-11-03T16:26:09Z 2015 Report 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 English en_US CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank World Bank, Washington, DC Economic & Sector Work :: Policy Note Economic & Sector Work East Asia and Pacific Mongolia |