The Dominican Republic is undertaking reforms, financed by a loan from the InterAmerican Development Bank, to improve access to primary health care services for 600,000 poor people in a three-year period. With the IDB loan, the DR has established a pilot project, FONAP, executed by the Reform Commission in coordination with the Ministry of Health, with technical support from The George Washington University Center for International Health. FONAP is a key project in the DR’s health reform process because it introduces separation of provision and funding of health services, promotes contracts and agreements with both public and private providers to provide a basic package of services for a capitation rate, establishes provider incentives linking accomplishments of goals with funding, and sets up community organizations to maintain accountability. Providers are to expand coverage by enrolling the population in their catchment area, especially women and children; FONAP subsidizes the capitation payment and enrollees make small co-payments at the time of using services.This presentation will describe key features of the design and implementation of the FONAP pilot effort, the financial and non-financial incentives built into the contracts, operation of incentives for health teams rather than individuals, and differences in motivation and institutional structure required for public and for private providers. Information will be based on observations and contract negotiations in the field and on baseline surveys to evaluate public and private provider practices.
Learning Objectives: Increase understanding of design and implementation of provider incentive systems for PHC services. Discuss links between health impacts and funding of PHC services, using providers incentives
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.