This volume analyzes Ghana s National Health Insurance Scheme and highlights the range of policy options needed to assure its financially sustainable transition to universal coverage.
This Simple Linear Actuarial Model (SLAM) manual is the accompanying publication to An Actuarial Model for Costing Universal Health Coverage in Armenia. It provides detailed guidelines in using the Microsoft Excel for SLAM. As an actuarial model, the SLAM calculates and presents the actuarial projections and key financial indicators to support the management of the health insurance programs nationwide and at local levels in assessing the overall costs and financial sustainability of health insurance programs. The goal is to have an actuarial model that they could update themselves without frequent intervention of actuarial experts and use for day-to-day management and assessment of alternative policy configurations of the health insurance schemes.
The Asian Development Bank seeks to assist the Government of Armenia in undertaking major health financing reforms to achieve universal health coverage (UHC) within the context of the Sustainable Development Goals and improving health system performance. Critical to the development, evaluation and implementation of such UHC policies is the need for accurate information of the expenditure implications and revenue needs of alternative policy choices. This report provides guidance in the design, construction, calibration, evaluation, implementation, use, and refinement of a UHC model to assess the expenditure impacts and the revenue requirements to finance alternative universal health insurance (UHI) policies. It develops an actuarial UHC costing model that relies on the most recent and complete health insurance claims data to estimate expenditures and revenue needs for achieving UHC. The report focuses on the development and operationalization of this actuarial model as a tool for assessing the health financing and fiscal implications of Armenia’s key UHI policy decisions.
The Asian Development Bank seeks to assist the Government of Armenia in undertaking major health financing reforms to achieve universal health coverage (UHC) within the context of the Sustainable Development Goals and improving health system performance. Critical to the development, evaluation and implementation of such UHC policies is the need for accurate information of the expenditure implications and revenue needs of alternative policy choices. This report provides guidance in the design, construction, calibration, evaluation, implementation, use, and refinement of a UHC model to assess the expenditure impacts and the revenue requirements to finance alternative universal health insurance (UHI) policies. It develops an actuarial UHC costing model that relies on the most recent and complete health insurance claims data to estimate expenditures and revenue needs for achieving UHC. The report focuses on the development and operationalization of this actuarial model as a tool for assessing the health financing and fiscal implications of Armenia’s key UHI policy decisions.
This Simple Linear Actuarial Model (SLAM) manual is the accompanying publication to An Actuarial Model for Costing Universal Health Coverage in Armenia. It provides detailed guidelines in using the Microsoft Excel for SLAM. As an actuarial model, the SLAM calculates and presents the actuarial projections and key financial indicators to support the management of the health insurance programs nationwide and at local levels in assessing the overall costs and financial sustainability of health insurance programs. The goal is to have an actuarial model that they could update themselves without frequent intervention of actuarial experts and use for day-to-day management and assessment of alternative policy configurations of the health insurance schemes.
Ghana is one of only several African countries to enact legislation and earmark financing for universal health insurance coverage for its entire population. Seven years into its implementation the Ghana National Health Insurance Scheme (NHIS) has made significant progress in transitioning to universal coverage, but faces significant fiscal and coverage challenges. This study reviews Ghana's health financing system with a special emphasis on its National Health Insurance Scheme. Such an assessment is important because Ghana is often considered a global 'good practice' in terms of earmarking significant amounts of its general revenues for health insurance coverage, providing formal coverage to its vulnerable population groups, and extending coverage by transitioning its existing community health insurance schemes into a national health insurance program. In addition to the global interest in the Ghana 'model', this review is timely in view of recent critiques of the system and questions about its financial sustainability. The study is also unique in terms of evaluating Ghana's NHIS in terms of basic health system goals of health outcomes, financial protection, consumer satisfaction, equity, efficiency, and financial sustainability. The strengths and weaknesses of Ghana's health financing system are assessed on the basis of these performance goals to provide the current health policy reform baseline. The assessment is also based on several new and updated sources of information on: total health spending, inputs, outcomes, household spending, and the macro economy. It also undertakes for the first time an extensive international benchmarking analysis; assesses the financial protection/equity of the system at both macro and micro levels; and, contains an extensive fiscal space analysis based on Ghana's new macroeconomic realities (i.e., the revaluation of Ghana's Gross Domestic Product (GDP) upward by some 60 percent in November 2010, making Ghana a lower middle income country). The study concludes with an assessment of potential structural and operational reform options to assure NHISs long-term efficacy and sustainability in the context of its future available fiscal space.
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