Health Financing and Insurance
The Department of Financing and Health Insurance is part of the Directorate of Policy Affairs at the Supreme Council of Health. Established in 2007, the Department aspires to develop state-of-the-art health financing and insurance systems that support the wider goals of the healthcare landscape and the National Health Strategy of the State of Qatar.
The overall vision of the Health Financing and Insurance Department is to help create the conditions that lead to ongoing improvements in the health care system by:
- Improving the efficacy and efficiency of healthcare spending and investment.
- Ensuring coverage and access to high quality health care at affordable cost for the entire population.
- Designing, strengthening and monitoring regulatory frameworks and policies relating to the performance of the social and private health insurance sector, and of healthcare services providers and funding agencies.
- Improving the efficacy and efficiency of health service providers.
- Reporting on and updating the evidence to support health financing and insurance policy development and implementation.
- Monitoring and evaluating health financing and insurance indicators.
Services and Activities
The Department focuses on three key areas:
- The development of health planning policies within the country’s healthcare system
- The development and implementation of policies relating to health economics and providing analytics for sound economic controls for the country’s healthcare needs
- The introduction of Social Health Insurance in Qatar.
Services and activities of the Health Financing and Insurance Department relate to policy design and development, project management and implementation in the following key areas:
- Oversee and manage policy development and projects for the design, implementation and monitoring of a social national health insurance scheme in the State of Qatar.
- Developing and implementing health economics activities, using comprehensive reporting methods, to support evidence-based decision making.
- Provide high level financial management support, process improvement, and advice to the Supreme Council of Health regarding health services budgets.
- Develop economic and forecasting activities and analysis.
- Develop, implement and monitor a program focused on classification and measurement of hospital admissions of patients.
- Lead and produce the annual Qatar National Health Accounts, which trace the flow of health spending and resource allocation within the whole health sector.
- Enhance data collection and data reporting methodologies of utilization, expenditure, and satisfaction for the health care system in Qatar. Baseline data is used to provide an objective perspective on health economic issues pertaining to the Social Health Insurance Project and to evaluate and forecast financial healthcare outcomes.
- Develop processes and relationships to assist budget preparation, reporting, administration, and expenditure/revenue controls for health services.
- Review state of costing and accounting methods, state of coding resources and skills and development of case-mix based information systems.
- Prepare output based funding policy guidelines.
- Implement Qatarization and capacity building policies. Supported by reviews and the further development of plans to ensure the meeting of Qatarization targets, including contingency plans for the transition when expat staff are replaced.
Social Health Insurance Scheme
A major driver of reform in the Qatari health sector is the provision of universal health coverage through the launch of a mandatory social health insurance scheme in Q1 2013. The scheme aims to:
- Improve access to health care services
- Enable people to have a wider choice of providers
- Improve quality of health care services
The scheme will be exclusively managed by the newly established National Health Insurance Company (NHIC).
The social health insurance scheme will be implemented in stages, with eligibility and coverage of the scheme extending to additional population groups, culminating in complete coverage of the population of the country, including visitors, by 2016.
As part of the scheme, the NHIC will enter into annual Provider Network Agreements with public and private health care providers. The funding of health care services will be primarily on an activity basis, underpinned by a standardized ’Fee Schedule’ which the Health Financing and Insurance Department has developed using international best practice health care costing methodology.
Key Documents for Providers and Stakeholders