Kosovo : Health Financing Reform Study

World Bank

Kosovo : Health Financing Reform Study

2008

World Bank

The objective of this report is to present information on the different health financing reform options available to Kosovo, which can help the government to make informed policy decisions about financing reforms. The report focuses on the key insurance functions of revenue collection and management, risk pooling, and purchasing of health care, as well as the supportive regulatory and governance framework for health financing. Kosovo aims to reform health financing by moving toward a health insurance system. To implement the proposed single insurer as described in the health law, a draft law for health insurance was discussed in Parliament in 2004. The draft law envisioned the revenue sources for the future health insurance as follows: (i) 60 percent of Health Insurance Fund (HIF) revenue will be paid by the general budget; (ii) 13.5 percent will come from payroll contributions; (iii) 21 percent will come from direct payments by patients in the form of user fees; and (iv) 6.5 percent will come from patients' co-payments. Three years later, in April 2007, the Kosovo Parliament approved a health insurance law to introduce social health insurance (SHI) financed predominantly through payroll taxes, though it did not specify contribution levels. The revenue potential of such payroll funded insurance was estimated to be modest considering Kosovo's relatively small formal sector and employment rate. The Kosovo health system is predominantly tax funded. Government health spending is about 3 percent of gross domestic product (GDP) and 10 percent of general government expenditures. The ministry of economics and finance (MEF) transfer's health funds from the central budget to hospitals (51 percent), to municipalities in the form of an earmarked health grant for the provision of primary health care (PHC) services (26 percent), and to the ministry of health (MOH) for other services (22 percent) (MEF 2007).

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AGROVOC Keywords

accountability circulatory system consumer protection corruption cost analysis decision making economic analysis health care health insurance health services hospitals human resource management human resources immunization income laws living standards medical equipment medicines morbidity mortality nongovernmental organizations patient patients pharmacies physicians pregnancy private sector public administration public expenditure public health public policies public sector quality control reproductive health resource allocation social insurance social security tuberculosis unemployment violence workers

Bibliographic information

Publisher

Washington, DC

Other Subjects

Free choice; Purchaser-provider split; Institutional arrangements; Health needs; Health strategy; Accountability mechanisms; Labor markets; Health care delivery; Fiscal decentralization; Health insurance companies; Health care providers; Health policy; Insurance companies; Health status; Medical savings accounts; Health care expenditures; Capital spending; Insurance systems; Ethical standards; Financial markets; Financial incentives; Public revenues; Health financing system; Fiscal situation; Delivery of health care services; Government revenue; Public expenditures; Health care system; Imperfect information; Delivery system; Provision of care; Health care centers; Informal payments; Private spending; Corrective action; Financial results; Health insurance fund; Budget process; Ministry of finance; Health care resources; Reform of health care; Public expenditure management; Provision of health care; Institutional capacity; Health systems; Health insurance program; Life expectancy; Provision of services; Hospital services; Health insurance plans; Inequity in health; National health insurance fund; Infant mortality; Primary health care; Moral hazard; Providers of health care; Health service; Health insurers; Health expenditures; Medical supplies; Quality of care; Health professionals; Health system; Labor market; Adequate safeguards; Central budget; Deaths; Revenue collection; Administrative arrangements; Life expectancy at birth; Payments for health care; Private health insurance; Childbirth; Administrative law; Institutional arrangement; Health financing reform; Health care services; Municipality; National health; Human resource; Health care personnel; Medical care; Hospital staff; Health savings accounts; Government expenditures; Financial protection; Social health insurance; Competencies; Tax revenues; Hospital care; Human development; Representatives; National health insurance; Risk sharing; Insurance funds; Patient satisfaction; Access to health care; Hospital beds; Illness; Health sector; Financial sector; Incentives for providers; Capitation payment; Risk adjusters; Health indicators; Health financing; Forecasts; Low-income countries; Information system; Pocket payment; Visits; Private insurance; Hospitalization; Outpatient care; Financing of health care; Health costs; Catastrophic health expenditure; Medical personnel; Legal provisions; Health outcomes; Health expenditure; Financial management; Treatments; Capitation; Health insurance system; Health law; Financial sustainability; Tax rates; Sickness funds; Health facilities; Health for all; Essential drugs; Pocket payments; Health care provider network; Good governance; Medical treatment; Physician; Administrative costs; Public health insurance; Delivery of health care; Equity in access; Health care facilities; Insurance market; Health insurance scheme; National health service; Fiscal policy; Provider payment; Contribution rate; Health care provider; Health insurer; Financial barriers; Public spending; Hospital admission; Budget constraints; Health organization; Informal economy; Health workers; Health spending; Primary care

License

http://hdl.handle.net/10986/8121http://creativecommons.org/licenses/by/3.0/World BankCC BY 3.0 Unported

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