A simple simulation model as a tool to assess alternative health care provider payment reform options in Vietnam

A simple simulation model as a tool to assess alternative health care provider payment reform options in Vietnam

Vietnam is currently considering a revision of its 2008 Health Insurance Law, including the regulation of provider payment methods. This study uses a simple spreadsheet-based, micro-simulation model to analyse the potential impacts of different provider payment reform scenarios on resource allocatio...

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Bibliographic Details
Published in:Global public health Vol. 10; no. sup1; pp. S104 - S119
Main Authors: Cashin, Cheryl, Phuong, Nguyen Khanh, Shain, Ryan, Oanh, Tran Thi Mai, Thuy, Nguyen Thi
Format: Journal Article
Language:English
Published: England Routledge 02-02-2015
Taylor & Francis Ltd
Subjects:
Appropriations and expenditures
Computer Simulation
Health care
Health care policy
Health Care Reform - economics
health financing
Health insurance
Health Policy
Health Services Research
Hospitals
Humans
Law
Medical service
Models, Econometric
Payment
Payments
provider payment
Public health
Regulation
Reimbursement Mechanisms - economics
Resource allocation
Risk
Simulation
simulation analysis
Social insurance
Social security
universal coverage
Universal Coverage - economics
Vietnam
Vietnam
provider payment
health financing
simulation analysis
universal coverage
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Summary:Vietnam is currently considering a revision of its 2008 Health Insurance Law, including the regulation of provider payment methods. This study uses a simple spreadsheet-based, micro-simulation model to analyse the potential impacts of different provider payment reform scenarios on resource allocation across health care providers in three provinces in Vietnam, as well as on the total expenditure of the provincial branches of the public health insurance agency (Provincial Social Security [PSS]). The results show that currently more than 50% of PSS spending is concentrated at the provincial level with less than half at the district level. There is also a high degree of financial risk on district hospitals with the current fund-holding arrangement. Results of the simulation model show that several alternative scenarios for provider payment reform could improve the current payment system by reducing the high financial risk currently borne by district hospitals without dramatically shifting the current level and distribution of PSS expenditure. The results of the simulation analysis provided an empirical basis for health policy-makers in Vietnam to assess different provider payment reform options and make decisions about new models to support health system objectives.
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ISSN:1744-1692
1744-1706
DOI:10.1080/17441692.2014.986156