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

Jordan
60% of JUH beds (300 beds) with an average cost of JD 429 per admission, while the
average cost of admission in all hospitals with which the Ministry of Health has formal and
informal contracts was JD 533 (Table 5).
• The agreements have some built-in mechanisms (utilization caps, liaison committees) to
monitor overall performance, control costs and solve problems.
Weaknesses and limitations
• The liberal referring practice in the Ministry of Health hospitals is increasing the financial
pressure on the Ministry of Health budget. In 2003, the cost of Ministry of Health
beneficiaries treated at JUH and KAH was 58% of the total costs paid for all non-Ministry of
Health hospitals (Table 5).
• Teaching hospitals, especially in the absence of practice protocols, tend to provide more
services than patients need. Thus, costs are more likely to increase.
Al-Hussein Cancer Centre
Al-Hussein Cancer Centre (HCC) was opened in 1997 as philanthropic, not-for-profit
hospital. The centre has 131 beds. It provides diagnostic, treatment and rehabilitation services for
cancer patients, including chemotherapy and radiotherapy. In 2001, the Ministry of Health and
HCC signed an agreement for medical and scientific cooperation.
Main features
• HCC provides medical services for the enrollees of the CHIP and uninsured patients who are
referred by the Ministry of Health.
• The Ministry of Health pays the treatment cost of its beneficiaries and the Ministry of
Finance pays the cost of the uninsured patients.
• Charges are paid according to HCC official charge scheme with 20% discount excluding
medicines.
• The Ministry of Health has a liaison office at HCC. The office checks eligibility of referred
patients, reviews and authorizes bills and coordinates all matters related to the
implementation of the agreement.
• HCC allocates 10% of its revenues from this agreement for the Cancer Research Fund.
• A joint cancer research committee from the Ministry of Health and HCC develops the cancer
research agenda, approves research projects and recommends the budget for each project.
• A higher coordination committee, headed by the general secretary of the Ministry of Health
with two senior members from each party, is formed to resolve problems and settle disputes
that may arise.
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