Primary Health Care Per Capita Payment Systems

READERSHIP OF THIS VOLUME

Many countries have adopted a general purchasing health services framework (Preker and Langenbrunner 2005), which specifies several components of purchasing, specifically: Core policy characteristics or “policy levers” that can be used for allocating, resources by purchasers across geographic areas or directly to providers, Organizational characteristics of providers and the incentive regimes within provider organizations and provider markets, Institutional characteristics embedded in the transactions that occur between different organizational units emanating from the government and across both public and private sectors. This area is similar conceptually to that outlined in The World Health Report 2000—Health Systems: Improving Performance(WHO 2000), which discussed this area as “stewardship” of the health sector.
In the short term, the use by purchasers of core policy levers can bring about
significant impacts in the delivery of care services. Core policy levers include
consideration of: Demand or “population coverage” (for whom to buy)?, Supply or “benefit package” (what to buy, in which form, and what to exclude)?, Factor and product markets or “contracting” (from whom, at what price to buy, and how much to buy)?, Prices and incentive regime or “provider payment systems” (at what price and
how to pay)?;
This volume focuses on the issues and experiences of one dimension (or policy lever) regarding the move to a strategic purchasing arrangement in a low- or middle-income country (or even geographic region), or within a public or private organization. Many argue that this dimension is one of the most important.
The volume also looks at issues of how to set prices and design the incentive regime or “provider payment systems” (box 1). Incentives can fundamentally change provider behavior, but purchasers must still set prices and decide exactly how to pay.
The intended readership includes health policy makers in low- and middleincome countries, and donor representatives or technical assistance specialists tasked with the design or implementation of health financing projects that include hospital payment reform, as well as (for health management information systems) technology managers.

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