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1、N!PAYMENTINCENTIVESFORIMPROVEDQUALITYOFHEALTHSERVICE!DELIVERYINREPUBLIKASRPSKAANDaiTHEFEDERATIONOFBOSNIAANDHERZEGOVINASenad HuseinagicSinisa Stevic Charles Birungi Adanna ChukwumaPa ZUouJnsoosQo=qndworldBankgroupHealth,Nutrition&PopulationPAYMENTINCENTIVESFORIMPROVEDQUALITYOFHEALTHSERVICEDELIVERYINR
2、EPUBLIKASRPSKAANDTHEFEDERATIONOFBOSNIAANDHERZEGOVINASenadHuseinagicSinisaStevicCharlesBirungiAdannaChukwumaApril2023Health,Nutrition,andPopulation(HNP)DiscussionPaperThisseriesisproducedbytheHealth,Nutrition,andPopulationGlobalPracticeoftheWorldBank.Thepapersinthisseriesaimtoprovideavehicleforpublis
3、hingpreliminaryresultsonHNPtopicstoencouragediscussionanddebate.Thefindings,interpretations,andconclusionsexpressedinthispaperareentirelythoseoftheauthor(s)andshouldnotbeattributedinanymannertotheWorldBank,toitsaffiliatedorganizations,ortomembersofitsBoardofExecutiveDirectors,ortothecountriestheyrep
4、resent.Citationandtheuseofthematerialpresentedinthisseriesshouldtakeintoaccountthisprovisionalcharacter.TheWorldBankdoesnotguaranteetheaccuracyofthedataincludedinthiswork.Theboundaries,colors,denominations,andotherinformationshownonanymapinthisworkdonotimplyanyjudgmentonthepartoftheWorldBankconcerni
5、ngthelegalstatusofanyterritoryortheendorsementoracceptanceofsuchboundaries.ForinformationregardingtheHNPDiscussionPaperSeries,pleasecontacttheEditor,Jung-HwanChoiatichoiwOrldbank.ororErikaYanickatevanickVVorldbank.orn.RIGHTSANDPERMISSIONSThematerialinthisworkissubjecttocopyright.BecausetheWorldBanke
6、ncouragesthedisseminationofitsknowledge,thisworkmaybereproduced,inwholeorinpart,fornoncommercialpurposesaslongasfullattributiontothisworkisgiven.Anyqueriesonrightsandlicenses,includingsubsidiaryrights,shouldbeaddressedtoWorldBankPublications,TheWorldBankGroup,1818HStreet,NW,Washington,DC20433,USA;fa
7、x:202-522-2625;e-mail:pubrightsworldbank.orgHealth,NutritionandPopulation(HNP)DiscussionPaperPaymentincentivesforimprovedqualityofhealthservicedeliveryinRepublikaSrpskaandtheFederationofBosniaandHerzegovinaSenadHuseinagicaSinisaStevicbCharlesBirungicdAdannaChukwumaeaHealthEconomist,Health,Nutrition,
8、andPc)PUIatiOnGlobalPractice,WorldBank,Washington,DC,UnitedStates.bHealthEconomist,Health,Nutrition,andPopulationGlobalPractice,WorldBank,Washington,DC,UnitedStates.cHealthEconomist,Health,Nutrition,andPopulationGlobalPractice,WorldBank,Washington,DC,UnitedStates.dFellow,TheUCLCentreforGlobalHealthE
9、conomics,UniversityCollegeLondon,London,UnitedKingdom.eSeniorHealthEconomist,Health,Nutrition,andPopulationGlobalPractice,WorldBank,Washington,DC,UnitedStates.Abstract:Thisreportoutlinesastrategicapproachtointroducepay-for-performance(P4P)incentivesforimprovednoncommunicabledisease(NCD)careinRepubli
10、kaSrpska(RS)andtheFederationofBosniaandHerzegovina(FBiH).DevelopedundertheHealthSystemsImprovementProject(HSIP)andMuIti-DonorTrustFund(MDTF)forHealthSystemsReform,theapproachfocusesonevidence-based,technicallysound,andpoliticallyfeasiblestrategies.Participatorilydeveloped,thereportsynthesizesgloball
11、essonsandanalyzesthepolicyenvironmentinRSandFBiH.Itproposeskeydesignfeatures,addressingstrategicopportunitiesandoperationalchallenges.Behavioraleconomicsinsightsandpoliticaleconomyfactorsinformtheapproach,identifyingkeylevers,opportunities,andchallengesaffectingP4Pimplementationcapacity.ToenhanceNCD
12、carequality,thereportrecommendschangesintheproviderpaymentmix,tailoredreformsatentityandcantonallevels,andactiveserviceuserengagement.Emphasizingtheimportanceoflinkingpaymentincentivestoperformance,theproposeddesignspansdimensionssuchasperformancemeasures,basisofpayment,paymentattributes,recipientof
13、payment,andtargetedoutcomes.Anenablingenvironmentisdeemedcritical.Relatedly,effectiveimplementationrequiresrobustdatasystems,stakeholderengagement,adaptedlegalframeworks,andsuitableinstitutionalarrangements.Technicalassistanceandbudgetarysupportneedsareidentified.ItisexpectedthatP4Pimplementationwil
14、lenhanceNCDcarecoverageandquality,therebyimprovinghealthoutcomesandoverallhealthsystemperformanceinRSandFBiH.Keywords:Healthfinancing,qualityofcare,pay-for-performance,noncommunicabledisease,BosniaandHerzegovina.Disclaimer:Thefindings,interpretationsandconclusionsexpressedinthepaperareentirelythoseo
15、ftheauthors,anddonotrepresenttheviewsoftheWorldBank,itsExecutiveDirectors,orthecountriestheyrepresent.CorrespondenceDetails:AdannaChukwuma,1818HStreet,NW,WashingtonDC20043,USA,Tel:+1(202)2129000,Email:achukwumawOrIdbank.orq,Website:TableofContentsAcknowledgmentsvAcronymsandabbreviationsviExecutiveSu
16、mmaryviiI. Introduction1II. CountryandSectorContext4A. PoliticalandEconomicContext4B. HealthSystemsPerformance5C. DemographicTrends9D. HealthGovernance10E. ServiceDelivery10F. HealthFinancing12G. DesignImplications17III. PaymentMethodology19A. Objectives19B. Measurement19C. Incentives19D. Adjustments20E. Recipients21F. Periodicity21IV. EnablingEnvironmen
