Achieving access to basic healthservices for the entire population without risk of financialhardship or impoverishment from out-of-pocket expenditures(‘universal health coverage’ or UHC) is a challenge thatcontinues to confront most low- and middle-income countries.As coverage expands in these countries, issues of financialsustainability, efficiency, and quality of care quickly riseto the surface. Strategic health purchasing is an importantlever to efficiently manage funds for UHC through thedefinition of what is purchased (which services and benefitsthe covered population is entitled to receive), from whomservices are purchase (which providers are contracted todeliver the covered services), and how and how much theproviders are paid. The assessment was conducted to helpinform the design and implementation of Mongolia’s providerpayment systems going forward. Health care provider paymentsystems, the way providers are paid to deliver the coveredpackage of services, are an important part of strategicpurchasing to balance system revenues and costs in a waythat creates incentives for providers to improve quality anddeliver services more efficiently. This ultimately makes itpossible to expand coverage within limited funds(Langenbrunner, Cashin and ODougherty 2009). In practice,however, provider payment systems are often under-utilizedas an effective tool to achieve UHC goals. After providing abrief overview of Mongolia’s health financing and servicedelivery system, this report describes the provider paymentassessment and summarizes the main findings. It discussesthe positive aspects and shortcomings of the current mix ofpayment systems and compares the design and implementationwith international good practices. The chapter concludes byproviding a roadmap for refining and realigning Mongolia’sprovider payment system going forward.
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