Evidence on Cost-sharing in Health Care : Applications to Hungary : Executive Summary
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Washington, DC
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This study, done at the request of the
Hungarian government, presents evidence on cost-sharing in
the health sector, and its application in Hungary. It
presents results on the impact of cost-sharing on revenues
in health facilities and insurance, financial
sustainability, informal payments, overall service use, and
equity in access. Five keyfindings emerge: cost-sharing
could lead to a reduction in unnecessary care provided to
insured patients who do not have to pay the full price of
care; cost-sharing could help reduce informal payments and
keep patient payments in the system; cost-sharing with
exemption policies are a prerequisite to provide equity in
access to care; cost-sharing could support cost containment
strategies; experience from OECD countries provides examples
of successful cost-sharing policies. Based on these
findings. the study recommends that Hungary continues to
monitor and evaluate the impact of cost-sharing on access,
to identify possible negative effects on equity in service
use. In Hungary, financial incentives through the provider
payment system could eventually support the effect of the
government supply-side strategy. Such financial incentives
could be set to providers through capitation payment to
reward better quality of care, and Diagnosis Related Group
(DRG) payments with expenditure ceilings with strict
utilization review and quality assurance control to set an
incentive for efficient provision of care.
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