Reviewing Healthcare Pricing and Payment Mechanisms: Strategies for Improvement in the Context of Expanding Health Insurance in Morocco

Abstract

Pricing and payment methods for health care services are important tools that encourage health establishments to provide more care with quality standards. In this regard, several countries have tried to develop their pricing and payment system for healthcare providers in order to contribute to the success of the generalization of health insurance. Through a literature review of an exploratory and comparative nature, the objective of this research is to describe the pricing and payment methods for healthcare services in Morocco and in other countries in order to evaluate the national model and draw lessons on areas for improvement in light of the generalization of health insurance. In Morocco, the generalization of fee-for-service pricing will meet the objective of extending health insurance, because it encourages healthcare establishments to increase their healthcare activities. However, a tariff revision based on cost studies is necessary in order to ensure adequate reimbursement to healthcare establishments in both the private and public sectors. For public healthcare establishments, we believe that it will be essential to complement fee-for-service payment with results-based budgetary financing in order to strengthen their effectiveness and efficiency. This improvement in budget allocation requires the development of an integrated information system that clearly describes hospital activity.