Improvement of Health Financing
(a) Support Hospital Financing Reforms
Strengthen transparency of and incentives for efficiency of the Health Insurance Fund financing for public hospitals through: (i) carrying out a phased implementation of a DRG payment system, including conducting a DRG costing exercise and building awareness and capacity of public hospitals' staff for the implementation of said payment system; (ii) carrying out a gradual shift of hospital acute care financing from inputs to DRGs; (iii) improving the information systems, through upgrades to central systems, and software installation or upgrades, as the case may be, at selected hospitals; (iv) supporting amendments to regulations and by-laws that give effect to the hospital financing reforms; (v) providing technical advice on options to improve efficiency of financing for non-acute care in hospitals and governance arrangements to strengthen management in hospitals; (vi) providing technical support to integrate hospital level Clinical Pathways into the E-health System for hospital information systems; (vii) defining admission criteria based on European Appropriateness Evaluation Protocol and adapting it to the national level; (viii) developing hospital matrix for performance monitoring and incentive for hospital staff; and (ix) improving the regulatory framework to: (A) recognize and define performance and expenditures; and (B) incorporate the DRG into the Health Insurance Fund's and hospitals' budgeting system.
(b) Strengthen Primary Health Care Financing
Improve the efficiency and quality of preventive and certain other primary care services through: (i) strengthening the incentives for performance in the Health Insurance Fund health provider payment mechanisms through refinement of performance criteria for variable payments made to health workers; (ii) designing and piloting implementation of Quality Improvement Subgrants for improvement of quality of health care, including increased access to health care and preventive services by vulnerable groups (such as Roma, the elderly, and the disabled); (iii) strengthening implementation and monitoring capacity of primary health care financing reforms through development of transition plans for capitation financing to Primary Health Care Centers and development and strengthening of managerial capacity and skills for heads of Primary Health Care Centers; (iv) developing proposals for amendments to regulations and by-laws that give effect to the primary care financing reform; and (v) providing technical support to integrate primary health care level Clinical Pathways into the E-Health System for primary health care information systems.
(c) Develop a Health Care Network Optimization Plan
Provision of technical support to (i) develop a health care network optimization plan for public health institutions; (ii) develop palliative care, outpatient care at hospitals and other interventions that may be necessary towards efficient utilization of existing capacities; and (iii) carry out advocacy activities.