Information Technology as a Tool for Health Insurance Schemes
An introduction to the JLN IT Track
Information technology represents an important tool in running an effective health insurance scheme. Information systems play an important role in:
- Enabling the identification and enrollment of under-served populations
- Facilitating the accurate and efficient processing of claims, benefiting governments and care providers alike
- Harnessing data to improve the long-term policies and management of the schemes
Maximizing IT’s potential, however, remains a major challenge for health insurance schemes across the JLN. Recognizing this challenge, the Rockefeller Foundation asked PATH and our partners, PharmAccess, the Public Health Informatics Institute (PHII), and Dr. Dennis J.
Provider Payment Mechanisms: The Anchor of Strategic Health Purchasing
An introduction to the JLN Provider Payment Mechanisms (PPM) Technical Track
Achieving access to basic health services for the entire population without risk of financial hardship or impoverishment from out-of-pocket expenditures (“universal coverage”) is a challenge that continues to confront most low- and middle-income countries. As coverage expands in these countries, issues of financial sustainability, efficiency, and quality of care quickly rise to the surface. Health provider payment mechanisms (PPM)--the way health care providers are paid to deliver the covered package of services—form the anchor of strategic health purchasing, which is an often under-utilized tool in the overall health financing policy toolkit. I recently co-authored a “How-To” manual published by the World Bank that has contributed to the growing awareness of the strategic role that PPM can play not only in reaching universal coverage, but also driving service delivery changes that make providers more responsive to the people they serve.