Introduction to Flagship Courses on : Health Sector Reform & Sustainable Financing

&Module 3 & 4:

Health System FinancingProvider Payment Systems

May 18-21, 2005Khoramabad - Lorestan

Dr Kambiz Monazzam

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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

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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”.

Nature of the health Challenges

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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

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ObjectivesObjectives of Health Reformof 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

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GlobalCore Courses

Asia Partners: China &Thailand

ECA Partners: Hungary & Russia

Africa Partners:SenegalFrancophone NetworkTanzania

Distance Learning & Knowledge Management

Operating Model

MENA Partners:Lebanon & Iran

LAC Partners: Chile & Mexico

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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

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Teaching Committee: Paul Shaw 1 Daniel Kress 1 Mark Roberts 2 William Hsiao 3 George Scheiber 4 Miriam Wiley 4 Richardo Bitran 5 Alexander Preker 6 Mark Basset 6 Robert Creighton 6 Lim Meng Kin 6 Tom Bossert 6

Coordinators:

Dr Sima RamadanDr Hadia Karam

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What Does Flagship Mean?

The first or commander ship usually with a flag on it

The best thing,

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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

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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

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Financing Affects What Goals?

Financing

Access to health care

Cost

Prevention

Quality ofServices

Health Status

RiskProtection

Public Satisfaction

Equity in distributing costs and benefits

Average and Distribution

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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

Goals of Payment Module

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Payment Affects What Goals?

payment

Access to health care

Cost

Prevention

Quality ofServices

Health Status

RiskProtection

Public Satisfaction

Equity in distributing costs and benefits

Average and Distribution