title: Assessment of systems for paying health care providers in Vietnam: implications for equity, efficiency and expanding effective health coverage.
abstract: Provider payment arrangements are currently a core concern for Vietnam's health sector and a key lever for expanding effective coverage and improving the efficiency and equity of the health system. This study describes how different provider payment systems are designed and implemented in practice across a sample of provinces and districts in Vietnam. Key informant interviews were conducted with over 100 health policy-makers, purchasers and providers using a structured interview guide. The results of the different payment methods were scored by respondents and assessed against a set of health system performance criteria. Overall, the public health insurance agency, Vietnam Social Security (VSS), is focused on managing expenditures through a complicated set of reimbursement policies and caps, but the incentives for providers are unclear and do not consistently support Vietnam's health system objectives. The results of this study are being used by the Ministry of Health and VSS to reform the provider payment systems to be more consistent with international definitions and good practices and to better support Vietnam's health system objectives.
authors.affiliation: a Ministry of Health , Health Strategy and Policy Institute , Hanoi , Vietnam.
authors.forename: Nguyen Khanh
authors.initials: NK
authors.lastname: Phuong
authors.forename: Tran Thi Mai
authors.initials: TT
authors.lastname: Oanh
authors.forename: Hoang Thi
authors.initials: HT
authors.lastname: Phuong
authors.forename: Tran Van
authors.initials: TV
authors.lastname: Tien
authors.forename: Cheryl
authors.initials: C
authors.lastname: Cashin
mesh_terms: D003430:Cross-Sectional Studies; D004526:Efficiency; D006291:Health Policy; D006302:Health Services Research; D006801:Humans; D007407:Interviews as Topic; D036301:Qualitative Research; D012051:Reimbursement Mechanisms / Q000458:organization & administration*; D019472:Universal Health Insurance / Q000191:economics*; D014744:Vietnam
keywords: Vietnam; capitation; health financing; health purchasing; provider payment; universal coverage