Enhancing the inclusion of vulnerable and High-Risk groups in Demand-Side health financing schemes in Cambodia: A concept for a Risk-Adjusted subsidy aapproach

R. Radermacher; S. Srivastava; M. Walsham; C. Sao; F. Paolucci

doi:10.1057/gpp.2016.5

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Enhancing the inclusion of vulnerable and High-Risk groups in Demand-Side health financing schemes in Cambodia: A concept for a Risk-Adjusted subsidy aapproach

Journal article

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Enhancing the inclusion of vulnerable and High-Risk groups in Demand-Side health financing schemes in Cambodia: A concept for a Risk-Adjusted subsidy aapproach

R. Radermacher, S. Srivastava, M. Walsham, C. Sao and F. Paolucci

The Geneva Papers on Risk and Insurance Issues and Practice, Vol.41(2), pp.244-258

2016

DOI: https://doi.org/10.1057/gpp.2016.5

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Abstract

Efforts are currently under way in Cambodia to expand the population coverage of social health protection schemes (health equity funds and voluntary insurance). Aligning the benefit packages for members of such schemes poses particular challenges in relation to the insurance component, as the financing of direct benefits in the insurance relies largely on the collection of voluntary premiums. This paper develops the concept of a targeted “risk-adjusted subsidy” approach to address this issue. Data on the health-seeking behaviour of insured households from Kampong Thom district over the course of one year (2010) are used to illustrate the concept. To retain the currently applied community rating and set incentives for cost effectiveness in administrative costs, as well as to avoid cream skimming (focusing on “good risks”), a risk-adjustment mechanism is proposed that would provide ex ante subsidies to insurance schemes according to the expected additional cost of a person joining the scheme. Although the concept is developed using the example of Cambodia, it is equally applicable to all developing countries facing fragmented risk pools while aiming for universal health coverage.

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Title: Enhancing the inclusion of vulnerable and High-Risk groups in Demand-Side health financing schemes in Cambodia: A concept for a Risk-Adjusted subsidy aapproach
Authors/Creators: R. Radermacher (Author/Creator) - Deutsche Gesellschaft für Internationale Zusammenarbeit
S. Srivastava (Author/Creator) - Swiss Tropical and Public Health Institute
M. Walsham (Author/Creator) - Oldham Council
C. Sao (Author/Creator) - Social Health Protection Association (SHPA)
F. Paolucci (Author/Creator) - Murdoch University
Publication Details: The Geneva Papers on Risk and Insurance Issues and Practice, Vol.41(2), pp.244-258
Publisher: Palgrave Macmillan
Identifiers: 991005544486507891
Murdoch Affiliation: Sir Walter Murdoch School of Public Policy and International Affairs
Language: English
Resource Type: Journal article

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Collaboration types: Domestic collaboration; International collaboration
Citation topics: 1 Clinical & Life Sciences; 1.14 Nursing; 1.14.364 Healthcare Policy
Web Of Science research areas: Business, Finance
ESI research areas: Economics & Business