Health financing

Benefit design

WHO /Eric Schwab
Medical assistant visiting a sick girl in her home

All countries face decisions about what to include in a publicly-funded benefit package for health. Decisions concern which health services to include, as well as related rules such as a requirement to use the referral system, making co-payments, or being subject to waiting lists.

Benefit package design is a key instrument to steer the health systems towards UHC. Decisions about priority services take into account information on cost-effectiveness, impact on financial protection, and equity in access across a population. Ensuring the effective delivery of benefits also requires coordination with policies on revenue raising, pooling, purchasing, and service delivery.

Benefit design in more detail

Benefits, rationing and UHC goals

All countries, whether rich or poor, limit service entitlements one way or another. This is called rationing, and decisions about how to ration benefits influences health system performance in terms of universal health coverage (UHC) goals.

Coverage choices facing purchasers

The UHC cube, used in the World Health Report 2010, reflects three dimensions of coverage; population coverage, service coverage, and financial coverage or financial protection.

Choosing interventions that are cost-effective (CHOICE)

A key objective for policymakers is to ensure the efficient use of resources. This calls for prioritising between and amongst a set of interventions. CHOICE aims to support such decision-making by providing evidence on those interventions and programmes which maximize health gain for the available resources.