Health Financing Strategies

The article is a World Health Organization guide to developing a health financing strategy authored by Joseph Kutzin, Sophie Witter, Matthew Jowett and Dorjsuren Bayarsaikhan targeting member states. The article gives an insight into the health financing strategies and discusses various concepts.

Universal health coverage

The Universal Health Coverage mainly implies the providence of a high quality affordable and accessible health services to the society in entirety. The policy is closely related to health financing and the health financing strategies and usually supported by politicians and other stakeholders to be actualized. The health system performance is unique for every country because of different challenges and resources. The performance is utterly dependent on the health system financing strategies to meet its goals and objectives to a population of a country. The health system strategies outline the sources of funds and how revenue is raised to champion the course, fund flow within and outside the organization via purchasing activities and other internal systems impacting on the fund adequacy and flow to meet a given service delivery plan.

Primarily, the Universal Health Coverage aims at predominantly depending on the public for funding of the program; mainly through taxation. Therefore, once the system is established and running in a predictable way, the program will benefit from enhanced stability and regular budget execution. The health financial strategies will examine the status of the health system of a country based on the actual performance against the set goals and targets (WHO, n.d).

Preparing for a health financing strategy

The first step of this process is conducting a situational analysis which summarizes the findings of the performance of the financial arrangement. Mainly, the major achievements and challenges are outlined and examined. The systems and processes will be scrutinized to bench-marked to the Universal health coverage goals and objectives to identify the gaps in another stage of action. Technically, this process will examine the current arrangements, performance problems and understanding the underlying causes.

Developing a health financial system

Noteworthy, it is the mandate of the national government to design and implement a financial health system that will add value to the stakeholders. Importantly, the system should be consistent with the UHC and mirror a particular setting regarding population, resource availability and the economy. Best practice approach to establishing the health financing system involves a multi-sectorial task force which will contribute a different expertise, knowledge, and concept. The stakeholders will include civil societies, NGOs, Association of health professionals, academic institution, and research bodies and private sector representatives. Consultations with the stakeholders, particularly those who will implement the system will be vital and also seek approval of the political class.

Raising and pooling of revenue

Revenue raising forms an integral part of the financial health strategy; which essentially should target the public's input through mandatory funding. This process should also be backed by reforms to check the spending of the funds ensuring value for money is achieved while the causes of under-performing are resolved and enhancement of execution.

Pooling of funds

The program will redistribute the funds collected to cover for the entire population regarding health services. Also, different funding sources can be pooled together to resolve societal inequalities and provide equitable, high-quality services to the population as a whole.

Purchasing services

Purchasing forms one of the expenditures of an organization; therefore, implementing best practice purchasing will be beneficial to the company. Essentially, the purchasing function should practice strategic purchasing by maintaining close relationship s with the suppliers, evaluating their performance and developing them. Actions for reforming the purchasing activity will focus on the payment systems and arrangements, information technology and many others. Once the program is set, the patients will be made aware of its existence, their entitlements and obligations while benefiting from the service. Also, an important aspect is the governance and restructuring of the program to effect enhanced performance. Example, changes in the roles of the participants, regulations and many others which will impact on the transparency and accountability in the sector.

Monitoring progress and evaluating the plan

The plan will be evaluated based on the performance indicators and the achievements of the policies and regulations set. Importantly, the desirable method of evaluations needs to be indicated in the plan, as for whether to outsource the service or manage it internally. Building capacity. Capacity building forms the last yet a vital stage in this process ensuring a successful implementation of the plan. Most essential aspects include expanding skills of participants to enable them effectively discharge their mandate.

Payment methodology

The payment methodology is merely the mode or style of payment for services or expenses incurred. Essentially, payment methodology ought to be compatible and acceptable with the organization. Most often, firms adopt e-payment methods to enhance the credibility and efficiency of the process (De Bruin et al., 2011).

Pay per performance

The pay per performance is an exercise of objectively paying for services based on an evaluation of their merits and value for money to the organization (Smith, 2007). Therefore, the firm is only obligated and liable for satisfactory performances that meet the acceptable standards while ignoring substandard performances (Eijkenaar et al., 2013).  The above concept is equated to fee-for-service which also utilizes data for past performances to make decisions regarding suppliers to engage.

Managed care plans

The government intervenes to manage health care systems to optimize the services to cater for the whole population (Shekelle & Goldzweig, 2009). Therefore, authorities solicit for funds mainly from the public and inject into health care plans to benefit the population.

References

De Bruin, S., Baan, C. & Struijs, J. (2011). Pay-for-performance in disease management: a systematic review of the literature. BMC Health Services Research, pp. 272.

Eijkenaar, F., Emmert, M., Scheppach, M. & Schöffski, O. (2013). Effects of pay for performance in health care: a systematic review of systematic reviews. Health Policy, pp. 115-130.

Shekelle P. & Goldzweig C. (2009). Costs and Benefits of the Health Information Technology, an Updated Systematic Review. London: Health Foundation for Southern California Evidence-Based Practice Centre, RAND Corporation

Smith, A. (2007). Merging P4P and the disease management, how do you know which one is working? Journal of Managed Care Pharmacy.

WHO (n.d). Documents on purchasing and provider payment systems. Retrieved on 28th December 2017 from http://www.who.int/health_financing/documents/purchasing/en/