1. Introduction to Flagship Courses on : Health Sector Reform & Sustainable Financing & Module 3 & 4: Health System Financing Provider Payment Systems May 18-21, 2005 Khoramabad - Lorestan Dr Kambiz Monazzam

2. 2 Nature of the health Challenges  Demographic & epidemiologic changes  Increase Age of population  New diseases & return of some old diseases  Increasing health costs  New technologies  Changing lifestyle toward unsafe behavior  Change to high cost diseases  Health policy making is not evidence based  Unavailable/Inaccurate Data & Information  Inaccurate Decision Making process/Methodology

3. 3  Money-Problem (Budget-Disease burden) Mismatch  Huge sums of money mismanaged  Health Sector Reform is complex  Limited Inter-country learning  Failure to complement advocacy about “What to Do” with “How to Do it”. Nature of the health Challenges

4. 4 History & Background:  1993: World Bank Report  1996: first annual global core course at WB  1996-2002: Bank introduce global + regional courses  80% of training now through 10 regional partner institutes  2003-2004: IRAN Flagship Course

5. 5 Objectives of Health Reform:  Improve health status of population  Improve consumer satisfaction  Assure financial protection  Enhance equity and access  Increase macroeconomic and microeconomic efficiency  Strengthen clinical effectiveness  Improve quality of care  Other!? Improve sustainability Effect on employment

6. 6 Global Core Courses Asia Partners: China & Thailand ECA Partners: Hungary & Russia Africa Partners: Senegal Francophone Network Tanzania Distance Learning & Knowledge Management Operating Model MENA Partners: Lebanon & Iran LAC Partners: Chile & Mexico

7. 7 2003-2004: IRAN Flagship Course: World Bank Institute American University of Beirut Harvard School of Public Health MOH & ME of Iran National Health Sector Reform Unit

8. 8 Teaching Committee:  Paul Shaw 1  Daniel Kress 1  Mark Roberts 2  William Hsiao 3  George Scheiber 4  Miriam Wiley 4  Richardo Bitran 5  Alexander Preker 6  Mark Basset 6  Robert Creighton 6  Lim Meng Kin 6  Tom Bossert 6 Coordinators: Dr Sima Ramadan Dr Hadia Karam

9. 9 What Does Flagship Mean?  The first or commander ship usually with a flag on it  The best thing,

10. 10 Objectives of Flagship course:  Reaching a method or approach to deal with complex (but similar) health system problems /finding solutions for them  Contributing to a ‘common language on reform’ among client countries  Responding to changing demand such as linking achieving the Millennium Development Goals

11. 11 Goals of Financing Module  Provide more in-depth knowledge of the financing control knob  Study the five methods of financing and compare their strengths and weaknesses  Provide tools — NHA and strategic framework for national financing  Work through a financing strategy for Iran

12. 12 Financing Affects What Goals? Financing Access to health care Cost Prevention Quality of Services Health Status Risk Protection Public Satisfaction Equity in distributing costs and benefits Average and Distribution

13. 13  Provide more in-depth knowledge of the payment control knob  Study methods of payment to providers in both inpatient & outpatient services and compare their strengths and weaknesses  Study effects of methods of payment on financial risk burden & Provider incentives  Understand contracting tool / process Goals of Payment Module

14. 14 Payment Affects What Goals? payment Access to health care Cost Prevention Quality of Services Health Status Risk Protection Public Satisfaction Equity in distributing costs and benefits Average and Distribution