Financing and Payment Models for Primary Health Care: Six Lessons from JLN Country Implementation Experience
In most countries, primary health care (PHC) providers are the first point of contact that most people have with the larger health care system. Primary health care is accessed the most by patients and can have the greatest impact on health outcomes compared with other parts of the system. However,
The JLN 2016 Global Meeting was held in Putrajaya, Malaysia from July 20th – 22nd, 2016, hosted by the Ministry of Health of Malaysia. The focus of the 2016 JLN Global Meeting was on building strong health systems to achieve universal health coverage (UHC) with an emphasis on strengthening integrated, peoplecentered health systems
The Bridge Between Private Healthcare Providers and National Health Insurance Programs is a case study report on how social franchises are linking private providers to the national health insurance program in the Philippines. This case study focuses on programs in the Philippines, a country that has been home to social
Thailand is still a lower middle-income country with the rural dominance in area and population. In each of the 800+ districts nationwide, a district hospital (DH) located in the district center and its network of 10-20 primary care units (PCUs), which are located at the sub-district level and act as the
Each private and public hospital in the Aarogyasri network conducts four health camps every month at which residents of Andhra Pradesh can receive free consultations and medications. These health camps are open to everyone, though only those eligible for the Aarogyasri scheme are eligible for referrals to network hospitals.
India's Aarogyasri scheme finances Aarogyamithras, or health coordinators, throughout the state. These Aarogyamithra both help promote the scheme, act as personalized support for patients throughout the scheme, and maintain the system’s records.
Ghana's National Health Insurance Scheme combines aspects of community-based health insurance and social health insurance in a hub-and-spoke model to more effectively target and enroll groups of informal sector workers.
Civil society organizations and local government units do community outreach to raise awareness and promote involvement in and usage of services provided by the UC scheme.
KaSAPI partners PhilHealth with existing microfinance institutions, rural banks, cooperatives, and other organized groups to better target and efficiently enroll groups of informal sector workers into the PhilHealth national insurance program (NHIP).
Mali is beginning the pilot phase of its national strategy to extend health coverage to 80% (informal sector and rural agricultural workers) of its population through mutuelles de santé, or community-based health insurance schemes (CBHI).
Kenya's National Hospital Insurance Fund is in the final stages of recruiting dealers for a new program that uses mobile phone technology and commercial intermediaries to expand enrollment and increase revenue. All other elements of the program are ready for a July 5th launch that will commemorate NHIF&rsquo
India's RSBY enters into agreement with private and public insurance companies to oversee scheme enrollment and manage claims processes. Insurers are selected based on an open bidding process, with one insurer per district. Insurer contracts can last up to three years based on insurer performance.
Intermediary organizations are engaged by RSBY insurance companies and the state government to ensure effective outreach to beneficiaries and facilitate their enrollment and utilization of benefits.
The Aarogyasri Health Insurance Scheme operates a Toll-Free Call Center that provides guidance on health related issues as well as information on benefits provided by the Aarogyasri scheme, registers complaints/grievances, digitizes information and coordinates activities with the field staff.
Nigeria's National Health Insurance Scheme is designing a software program for the Voluntary Contributors System that improves on the existing Enrollee Database Management System. The new program will have a user-friendly, secure and interactive public interface that allows for online registration and payments, giving enrollees greater control over individual