Health Financing

The Abt Associates-led PSP-One project provides technical assistance, evidence, and tools to improve the financial environment and conditions for private provision of reproductive health, family planning (RH/FP) and other health products and services. The project’s focus on financing alternatives reduces financial barriers to access and promotes quality and equity of access to RH/FP and other health services for the poor and underserved.

PSP-One works with representatives of the public and private sectors to develop partnerships built on effective design and implementation of sustainable financing policies and practices. The project collaborates with counterparts to design, implement, and evaluate financing alternatives and service delivery models that provide incentives for private provision of high-quality services and products targeted to poor and underserved populations.

These include:

Develop targeting mechanisms that ensure improved access for the poor and underserved in receiving RH/FP and other health services from public and private sector providers.
Develop voucher schemes that provide greater access to RH/FP and other health services for the poor and generate more reliable and sustainable income for private providers delivering services they may not otherwise target to the underserved.
Design alternative provider payment methods that provide incentives for private providers to expand coverage for the poor and create sustainable revenue. Several types of provider payment methods (e.g., fee for service, capitation, diagnosis-related groups, bundled rates, global budgets) can be combined to provide incentives that translate into lower and more efficient costs for public sector subsidies, especially when incorporated into contracting mechanisms.
Work with counterparts to develop or expand private insurance, community-based health insurance, social insurance, and other methods for pooling financial risk for RH/FP and other health services and products in order to increase both affordability for clients and financial sustainability for providers.
Work with counterparts to improve effectiveness of decentralized units in developing alternative financing and contracting mechanisms for private providers.
Develop policies and plans for the financing requirements for sustainable scale-up of successful models of public/private partnerships.
Collaborate with the Banking on Health project to assess the impact of financing mechanisms on private sector financial viability.

One of PSP-One’s most important contributions to financing is technical assistance, research, and systematic evaluation that will establish a solid evidence base of what financing alternatives work best to achieve the dual goals of expanded, high-quality private provision and increased equity in the delivery of RH/FP and other health services.

Conduct cost-effectiveness studies of alternative ways to deliver RH/FP services that provide greater private sector access to the poor and expand the private sector’s market share for RH/FP services.
Design and evaluate pilot or demonstration projects that test the feasibility and effectiveness of alternative financing and contracting mechanisms aimed at increasing private provision of and equity of access to RH/FP and other health services and commodities.
Conduct willingness-to-pay studies that help set prices that can reduce financial barriers faced by consumers in using private health services and that guide marketing strategies for private providers and provider networks.
Prepare and disseminate syntheses of current knowledge of financing mechanisms that promote the private sector’s equitable provision of RH/FP services.
Develop and disseminate tools for expanding private provision of RH/FP and other health services and ensuring equity through strategies related to pricing, market analysis, willingness-to-pay surveys, cost-effectiveness criteria, provider payment guides, contracting out guides, and monitoring and evaluation indicators to assess the impact of financing alternatives.
Build consensus on knowledge gaps, opportunities, and needed research and evaluation to expand the private sector provision of RH/FP and other health services and commodities through new financing mechanisms.

Current Activities

PSP-One is currently in the process of developing:

Primers on the impact of contracting out and health insurance schemes on access to RH/FP and other health services
A technical review paper on state-of-the-art financing mechanisms for private provision of RH/FP services.
A financing alternatives framework for the Asia Near East region to increase private sector provision of and improve client access to RH/FP services and commodities.
A panel discussion on willingness-to-pay tools, how organizations currently use these tools to inform pricing decisions, and the effects of pricing decisions on the reproductive health market and access to reproductive health services and commodities.