Guideline 26. Ensuring the financial sustainability of health coverage | International Social Security Association (ISSA)

Introduction
Objectives of the ISSA Guidelines on Administrative Solutions for Coverage Extension
Structure of the ISSA Guidelines on Administrative Solutions for Coverage Extension
A. General Administrative Approaches for Coverage Extension
Guideline 1. Assessing the enabling environment
Guideline 2. Securing the required authority for coverage extension
A.2. Ensuring Institutional Readiness
Guideline 3. Formulating a strategic coverage extension plan
Guideline 4. Leveraging partners in administering the scheme
Guideline 5. Setting appropriate standards for different services and facilities
Guideline 6. Establishing adequate ICT capacity
Guideline 7. Putting in place a responsive administrative structure
A.3. Informing, Increasing Awareness and Reaching Out to Difficult-to-Cover Groups
Guideline 8. Establishing a communication strategy to make contact and build trust with population groups that are difficult to cover, including informal-economy workers
A.4. Developing an Effective Registration System
Guideline 9. Establishing an identification system
Guideline 10. Simplifying information requirements for registration
Guideline 11. Facilitating the registration process
Guideline 12. Implementing data quality assurance mechanisms
A.5. Identifying Proper Solutions to Collect Contributions and Improve Compliance
Guideline 13. Formulating appropriate bases for the establishment of contribution rates
Guideline 14. Adopting appropriate methods for and frequency of contribution payments
Guideline 15. Collaborating with other organizations to collect contributions and enforce compliance
Guideline 16. Supporting voluntary compliance and formalization
Guideline 17. Adopting a proactive strategy on addressing administrative error, evasion of contributions and fraud
A.6. Delivering Services and Benefits in a Timely, Accurate and Effective Way
Guideline 18. Formulating a service delivery plan
Guideline 19. Making optimal use of electronic payment and e-services
Guideline 20. Maintaining an adequate network for personally delivered/virtual services
Guideline 21. Improving coordination and the portability of social security rights and benefits
B. Defining a Regulatory Strategy to Ensure the Sustainability of Health Coverage and Build Confidence across the Population
Guideline 22. Refining the study of the enabling environment to meet the specificities of health coverage
Guideline 23. Establishing quality health care for the whole population, with no exceptions
Guideline 24. Strengthening the population’s access to health care throughout the country
Guideline 25. Regularly evaluating the efficiency of health care provision
Guideline 26. Ensuring the financial sustainability of health coverage
Guideline 27. Developing and disseminating health information campaigns
Guideline 28. Safeguarding coverage through a specific regulatory plan
Guideline 29. Improving health security in the field of health care products
Guideline 30. Regulating expenditure on health care products and improving usage
Guideline 31. Helping to secure the supply of health care products
Guideline 32. Improving individuals’ health by promoting the screening for and prevention of chronic and debilitating conditions
C. Covering the “Missing Middle”
Guideline 33. Defining the population group to cover
Guideline 34. Building an inventory of social security benefits
Guideline 35. Defining the formalization and transition strategies
Guideline 36. Defining the economic model of the schemes
Guideline 37. Establishing permanence conditions in the schemes
Guideline 38. Defining a communication strategy
Guideline 39. Simplifying administrative processes: Registration and enrolment
Guideline 40. Simplifying administrative processes: Contribution collection
Guideline 41. Simplifying administrative processes: Procedures and tools for accessing benefits
Acknowledgements

The institution, within the bounds of its competences and in conjunction with other stakeholders (see Figure 1), contributes to the financial sustainability of health coverage through the use of sustainable funding and by allocating resources to the most efficient health care provision possible.

ISSA Guidelines:

Administrative Solutions for Coverage Extension

ISSA Guidelines:

Administrative Solutions for Coverage Extension

Administrative Solutions for Coverage Extension -
Guideline 26. Ensuring the financial sustainability of health coverage

Centre for Excellence

Administrative Solutions for Coverage Extension - Guideline 26. Ensuring the financial sustainability of health coverage

Centre for Excellence

Administrative Solutions for Coverage Extension -
Guideline 26. Ensuring the financial sustainability of health coverage