The Government of Kazakhstan is undertaking large scale health sector reforms, including the reorganization of health financing and service purchasing systems, to achieve better health outcomes of the population.
Tata Chanturidze, Mike Naylor, Sam Franzen, Tomas Lievens
We are supporting the Government of Kazakhstan in health policy, health financing, and service purchasing reforms since 2010. This is a second project we have implemented aimed at enhancing the capabilities of the Ministry of Health and Social Development (MHSD) in evidence-based policy, improving provider payment systems for inpatient and outpatient services, and strengthening the capabilities of health service purchaser. The project includes work for introduction of Social Health Insurance (SHI) in Kazakhstan, and one of the main challenges is the complexity and time constraints for developing the SHI system in a budget-funded healthcare sector.
There are three main elements to our approach.
1. Supporting the development of the SHI concept and introduction of SHI. This includes supporting:
- the elaboration of a SHI concept, SHI governance framework, and road map;
- the organisational structure of the SHI fund;
- the development of SHI regulations;
- capacity building for SHI fund staff
- the revision of the State Guaranteed Benefit Package; and
- actuarial estimations for SHI contribution rates.
2. Supporting the strengthening of service purchasing mechanisms for outpatient and inpatient services, including development of:
- diagnostic-related groups (DRG) for hospital services, including DRG logic, cost-weights, DRG Coding guidelines, DRG regulations, and capacity building; and
- capitation base payments and pay for performance mechanisms for outpatient services.
3. Supporting institutionalisation of National Health Accounts (NHAs).
Our outcomes will be the development of Social Health Insurance System and improved health service purchasing mechanisms that, once implemented, will help the country to increase effectiveness, efficiency, equity and coverage with healthcare services nationally.