Designing and Implementing Health Care Provider Payment Systems

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Designing and Implementing Health Care Provider Payment Systems: How-To Manuals

The chapter emphasizes the important role of information technology. Computers are becoming cheaper, and more easily managed—hence more ubiquitous. But telecommunications are also needed. Staff must be trained to operate these new, often-combined, systems.

The challenge in an HMIS is to implement regulations, policies, and procedures aimed at standardizing systems. The days of “one-of-a-kind” custom-built systems are coming to an end, for these are far too costly to build, hard to maintain, and almost impossible to integrate into larger systems as the need arises. Issues that an HMIS must address are confidentiality, standards and their enforcement, and payment for services provided. With the proper policies and procedures, a country can reap great benefits from an HMIS; without them, health care systems may fail to fully exploit the benefits (including cost-savings) of an HMIS.

NOTES 1. Some of these chapters were previously published separately as World Bank Health, Nutrition and Population discussion papers.

2. However, the literature does have some dissenting evidence—Palmer and Mills (2003) found that part-time fee-for-service surgeons in rural South Africa expended minimal time on their public sector patients.

REFERENCES Aas, I. 1995. “Incentives and Financing Methods.” Health Policy 34 (3): 205–220.

Arrow, K. 1963. “Uncertainty and the Welfare Economics of Medical Care.” American Economic Review.

Bitran, R., and W. Yip. 1998. “A Review of Health Care Provider Payment Reform in Selected Countries in Asia and Latin America.” Major Applied Research 2, Working Paper 1. Partnerships for Health Reform Project, Abt Associates Inc., Bethesda, MD. Bodenheimer, T., and K. Grumbach. 1994. “Reimbursing Physicians and Hospitals.” Journal of the American Medical Association 272 (12): 971–977.

Chinitz, D., and B. Rosen. 1993. “A Tale of Two Markets: Hospital Competition in Israel.”

Brookdale Institute RR-30-93, Jerusalem, Israel.

Diop, F. 2002. “Community Financing in Rwanda: Early Results.” Presentation at the World Bank, Workshop on Community-Based Health Insurance, February, Washington, DC. Dranove, D., and M. Satterthwaite. 2000. “The Industrial Organization of Health Care Markets.” In Handbook of Health Economics, ed. A. J. Culher and J. P. Newhouse. Amsterdam: North-Holland.

Duckett, S. 1995. “Hospital Payment Arrangements to Encourage Efficiency: The Case of Victoria, Australia.” Health Policy 34 (2): 113–134.