The role of contractual arrangements in improving health sector ...

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Other private hospitals Al-Hussein Cancer Centre Flow of Services Flow of Funds RMS Jordan Ministry of Health KAH Figure 2. Contractual arrangements between the Ministry of Health and other health care providers 126 JUH Al-Mowasah and Al-Hayah hospitals Lozmila and Red Crescent hospitals
Fee-for-service contracts Royal Medical Services Jordan The agreement with Royal Medical Services (RMS) was signed in 1982. It defines and organizes the relationship between the main two public providers of health care in the country. According to this agreement, patients and funds flow from both directions (Figure 2). Thus, beneficiaries of civil and military health schemes can have access within certain conditions, to the Ministry of Health and RMS health facilities. Main features • Beneficiaries of the Civil Health Insurance Plan (CHIP) may be referred by the Ministry of Health hospitals for treatment at King Hussein Medical Centre. • Beneficiaries of the CHIP who live in Aqaba and Tafilah governorates are treated at RMS hospitals (Ministry of Health does not have hospitals in either governorate). • Beneficiaries of the Military Health Insurance Plan (MHIP) are treated at any Ministry of Health health centres near their residence. • Beneficiaries of the MHIP can be treated in the Ministry of Health hospitals in cities that lack RMS hospitals (i.e. Ajlun, Ma’an, Jarash, Mafraq). • Charges will be paid by each party according to fee-for-service as specified in the official fee schedule for the Ministry of Health and RMS, with 30% discount. • Emergency cases for beneficiaries of both sides are treated in the Ministry of Health or RMS facilities. • A joint committee from both sides meets every three months or ad hoc to review claims, settle accounts and resolve problems. • The annual financial balance for the past three years has been almost zero, with a total cost of approximately JD 5 million for each party. Strengths • Improves patients’ access to Ministry of Health and RMS health facilities. • Improves equity to beneficiaries from both parties by giving them the chance to benefit from health resources available at the Ministry of Health and RMS facilities. • Minimizes duplication of services and improves economic efficiency in the Ministry of Health and RMS. Thus, the Ministry of Health does not have to invest in tertiary medical services available in RMS hospitals, and RMS does not have to invest in establishing health centres or hospitals in locations served by MOH facilities. • Needs minimum monitoring and auditing efforts from both sides as the two parties are public not profit driven organizations. This is reflected clearly in Table 5, which shows that the cost per admission in RMS was JD 295, while it was JD 1563 in private hospitals with no formal contracts and JD 583 in all hospitals.
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Morocco Draft The role of contractu
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CONTENTS FOREWORD..................
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The role of contractual arrangement
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Islamic Republic of Iran care (incr
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Afghanistan AFGHANISTAN 37
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Current health services delivery Af
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Afghanistan with the staff of the M
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Afghanistan 3) Greater emphasis cou
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Afghanistan Table 2. Implementation
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Provider Strengths Afghanistan •
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Bahrain BAHRAIN
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Bahrain services to be contracted-o
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Bahrain claiming under them respect
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Financing Bahrain There is a clear
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Bahrain receipt of the invoice. The
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Bahrain RESULTS AND DISCUSSION: CAS
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Bahrain The competitive bidding pro
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Bahrain 11. SMC Cleaning Services C
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INTRODUCTION Egypt The health secto
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Egypt are governed by their own set
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Egypt One of the key objectives of
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Egypt Is the legal framework robust
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Egypt The opportunity for the HSRP
Page 75 and 76: Egypt The Research Unit includes Fa
Page 77 and 78: Egypt How was the nongovernmental o
Page 79 and 80: Egypt How did the approved list of
Page 81 and 82: Egypt districts, where private and
Page 83 and 84: Egypt Annex 1 Contract copy between
Page 85 and 86: Egypt deposit the fees of opening n
Page 87 and 88: Islamic Republic of Iran ISLAMIC RE
Page 89 and 90: INTRODUCTION Islamic Republic of Ir
Page 91 and 92: Islamic Republic of Iran OVERVIEW O
Page 93 and 94: Delivery Facility Health House Sour
Page 95 and 96: Islamic Republic of Iran PBSC invol
Page 97 and 98: Islamic Republic of Iran authoritie
Page 99 and 100: Islamic Republic of Iran From an ad
Page 101 and 102: Islamic Republic of Iran 6. Shieber
Page 103 and 104: Medical Sciences University Islamic
Page 105 and 106: Jordan JORDAN
Page 107 and 108: INTRODUCTION Jordan This study docu
Page 109 and 110: Jordan hospital beds in Jordan. In
Page 111 and 112: Jordan health education programmes.
Page 113 and 114: Jordan Benefits by health subsystem
Page 115 and 116: Jordan Table 2. Summary of health e
Page 117 and 118: Jordan ASSESSMENT OF OVERALL CAPACI
Page 119 and 120: Jordan attract foreign investment,
Page 121 and 122: Jordan businesses efficiently. The
Page 123 and 124: Expected risks and incentives Minis
Page 125: Jordan Table 4. Profile of contract
Page 129 and 130: Jordan King Abdullah Hospital (KAH)
Page 131 and 132: Strengths Jordan • Provides acces
Page 133 and 134: Jordan • The minimum charge scale
Page 135 and 136: Jordan The main reasons behind the
Page 137 and 138: Jordan • Interviews with the Mini
Page 139 and 140: Jordan • This type of contracting
Page 141 and 142: Jordan CONCLUSIONS AND RECOMMENDATI
Page 143 and 144: Jordan 3. Prospective payment mecha
Page 145 and 146: Jordan Annex 1 CONTRACT/AGREEMENT A
Page 147 and 148: Lebanon LEBANON
Page 149 and 150: Lebanon at their disposal for regul
Page 151 and 152: Research methods and data sources L
Page 153 and 154: Lebanon and local municipalities. E
Page 155 and 156: Lebanon Table 1. Contractual arrang
Page 157 and 158: Lebanon Table 3. Costs of contractu
Page 159 and 160: Lebanon performance or mechanisms f
Page 161 and 162: Lebanon Overall, the contracts allo
Page 163 and 164: Lebanon belong to the Ministry of S
Page 165 and 166: Lebanon Perhaps the more obvious di
Page 167 and 168: Lebanon quality of care in the cont
Page 169 and 170: Lebanon Correcting this imbalance b
Page 171 and 172: Lebanon could be a first step towar
Page 173 and 174: Lebanon Table 5. Scorecard of contr
Page 175 and 176: Lebanon support for wide reform and
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Lebanon Sabri B et al. Health secto
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INTRODUCTION Morocco During the pas
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Morocco A contractual arrangement i
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Morocco services, as the administra
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Morocco The programme budget is lik
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Morocco According to his Act, each
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Morocco The number of patients curr
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Morocco facilities and the technica
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Morocco Evaluation of the subcontra
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Morocco Annex 2 EVALUATION OF THE E
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Chefchaouen Reassignment of agents,
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Ain Seb. Hay Moh. S. B. Zenata El F
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Pakistan PAKISTAN
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Pakistan To improve the health stat
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Pakistan the government grants a co
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Pakistan The relevant documents wer
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Pakistan Table 1. Examples of contr
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Pakistan Each contract generally sp
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Pakistan services. The specialized
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Pakistan Case study: contractual ar
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Pakistan used in the project to col
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Pakistan GFATM support, and a Natio
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RECOMMENDATIONS Pakistan 1. Conduct
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Pakistan Annex 1 GUIDELINES FOR DIS
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Pakistan Question Discussion points
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INTRODUCTION Tunisia The health ins
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Tunisia hospital facilities may be
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Tunisia the regulations of the mutu
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Tunisia pocket household expenditur
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Tunisia The Tunisian health strateg
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Table 2. Distribution of agreements
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Tunisia Coverage of MRI procedures
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under the agreements, 1995-2004 Tun
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Tunisia Table 5. Beneficiaries (BEN
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Tunisia The National Pension and So
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Tunisia Table 8 shows an increase i
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Tunisia to the private sector. The
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CONCLUSIONS Tunisia Three closely i
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