Verification of Performance in Results-Based Financing Programs
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World Bank, Washington, DC
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Verification in results-based financing
(RBF) mechanisms is one of the key differentiators between
it and related health financing structures such as social
health insurance. Verifying that providers have achieved
reported performance in RBF mechanisms is considered a
crucial part of program implementation and key to
maintaining trust through transparency, as well as the
viability of the mechanism. Verification is however a
process which has thus far been little studied. Information
on the methodologies used in different settings (including
frequency and sampling methodology), the effectiveness of
the verification process, the direct and tangential effects,
and the cost is scarce. Plan Nacer employs one of the
largest RBF mechanisms in the world and is therefore an
excellent case study for the role, methodology and effects
of the verification process. This study will give the
background to Plan Nacer, detail the major characteristics
of the verification process and draw lessons on the process
which can inform the design of verification in RBF
mechanisms in other countries.
Palabras clave
ADOLESCENTS, ALLOCATION OF RESOURCES, AMBULANCE, AMBULANCE SERVICES, ATTRIBUTES, BABIES, BASIC, BASIC HEALTH SERVICES, BEST PRACTICES, BOOKMARK, CAPITATION, CHILD HEALTH, CHILD MORTALITY, CHILDBIRTH, CLINICS, DATA SOURCES, DEATHS, DECISION MAKING, DELIVERY CARE, DISSEMINATION, DRUGS, EARLY DETECTION, EQUIPMENT, FEE FOR SERVICE, FINANCIAL MANAGEMENT, FINANCIAL PERFORMANCE, FINANCIAL SUPPORT, FUNCTIONALITY, GEOGRAPHICAL AREAS, GROSS DOMESTIC PRODUCT, HEALTH CARE, HEALTH CARE CENTERS, HEALTH EXPENDITURE, HEALTH FACILITIES, HEALTH FINANCING, HEALTH INDICATORS, HEALTH INSURANCE, HEALTH OFFICIALS, HEALTH OUTCOMES, HEALTH PROVIDERS, HEALTH RESULTS, HEALTH SECTOR, HEALTH SECTOR REFORM, HEALTH SERVICE, HEALTH SERVICES, HOSPITAL, HUMAN RESOURCES, IMAGING, IMMUNIZATION, INCOME, INFANT, INFANT MORTALITY, INFANT MORTALITY RATE, INFANTS, INFORMATION PROCESSING, INFORMATION SYSTEM, INFORMATION SYSTEMS, INNOVATION, INSTITUTION, INSTITUTIONAL FRAMEWORK, INSURANCE SCHEMES, INTEGRATION, INTERNATIONAL STANDARDS, INTEROPERABILITY, INTERVENTION, LIVE BIRTHS, MATERIAL, MATERNAL DEATHS, MATERNAL MORTALITY, MATERNAL MORTALITY RATIO, MEASLES, MEDICAL PROFESSIONALS, MEDICAL STAFF, MEDICAL SUPPLIES, MILLENNIUM DEVELOPMENT GOALS, MINISTRY OF HEALTH, MISSING DATA, MORBIDITY, MORTALITY, MOTHER, MUMPS, NATIONAL GOVERNMENT, NATIONAL LEVEL, NATIONAL RESOURCES, NEONATAL CARE, NEWBORN, NEWBORN INFANTS, NEWBORNS, NUMBER OF BIRTHS, NUMBER OF PEOPLE, NUTRITION, PATIENT, PERINATAL CARE, PREGNANCY, PREGNANT WOMEN, PRENATAL CARE, PRIMARY HEALTH CARE, PROGRESS, PROTOCOLS, PROVISION OF SERVICES, PUBLIC HEALTH, PUBLIC HEALTH SERVICES, PUBLIC POLICY, PUBLISHING, QUALITY OF CARE, QUALITY OF SERVICES, REGISTERS, REGISTRIES, REGISTRY, REGULATORY FRAMEWORK, REPRODUCTIVE HEALTH, RESPECT, RESULT, RESULTS, RUBELLA, SERVICE DELIVERY, SERVICE PROVISION, SERVICE QUALITY, SOCIAL HEALTH INSURANCE, SOCIAL SECURITY, SOFTWARE PACKAGES, SUPERVISION, SUPPORT STAFF, SURGERY, TARGETS, TECHNICAL ASSISTANCE, TETANUS, TRANSACTION, TRANSPORTATION, UNIQUE IDENTIFIER, USER, USES, VACCINATION, VERIFICATION, VERIFICATIONS, YOUNG CHILDREN