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Health Provider Payment Reforms in ChinaThis paper examines health provider
 payment reforms in China the present system and how it
 evolved, and changes that will improve it in the context of
 ongoing health reform. The paper begins with a brief
 introduction and background discussion followed by two
 substantive sections experiments with case-based payment
 systems, and experiments with alternative government budget
 payment methods. This is followed by an examination of what
 has worked in China and elsewhere. The concluding discussion
 considers lessons for China and next steps. Many policy
 instruments and reforms have been implemented to use
 National Cooperative Medical System (NCMS), Basic Medical
 Insurance (BMI), and government health budgets more
 efficiently. These include alternative payment systems,
 reduced drug prices, essential drug lists, controlled use of
 high technologies, and strengthening the primary healthcare system.
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Lessons for Hospital AutonomyThe Government of Vietnam sees hospital
 autonomy policy as important and consistent with current
 development trends in Vietnam. It is based on government
 policies as laid out in government Decree on financial
 autonomy of revenue-generating public service entities; and
 to 2006, it is replaced by decree on professional,
 organizational, human resource management and financial
 autonomy of revenue-generating and state budget-financed
 public service entities. These policies apply to public
 service entities in all sectors, including the health sector
 and hospitals. This policy is an important element of public
 administration reform in Vietnam, helping service entities
 survive and develop under the socialist-oriented market
 mechanism. It aims to help hospitals in fulfilling assigned
 professional tasks by allowing them to restructure their
 organization and staffing. The government has also allowed
 public service entities to mobilize private capital and
 joint ventures to organize activities and services
 responding to social and people's needs. This study
 will show that since the implementation of decrees, a number
 of improvements have been demonstrated within hospitals with
 respect to physical facilities, service provision, medical
 techniques, service quality and staff incomes, thus creating
 stability and satisfaction among hospital workers. But it
 also describes the international evidence that
 implementation of hospital autonomy comes with a risk of
 unintended outcomes driven by powerful financial incentives
 from the market place to increase revenue. These include
 supply induced demand, cost escalation, inappropriate care.
 There are some indications that such risks may be emerging
 in Vietnam as well, although these would need further
 research. Fortunately, there is also international evidence
 about policies that can mitigate such risks, and these are
 also described in this report. This report will inspire
 further studies and encourage policymakers to think about
 continuous improvement of policies.
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Massachusetts Health Reform : Approaching Universal CoverageThe commonwealth of Massachusetts, one of the 50 states in the United States of America, has achieved near universal health coverage of its 6.6 million residents after a landmark reform made health insurance mandatory for all residents in 2006. The reform was only the latest step in a sequence of national and state programs that successively enrolled more people in private and public health insurance programs over a period of four decades. Massachusetts passed chapter 58 of the acts of 2006, the Massachusetts health care reform law, on April 12, 2006, and over a five-year period, more than 400,000 previously uninsured residents were provided with comprehensive health benefits. As of 2012, 98.2 percent of the population is covered, including 99.8 percent of children. Massachusetts has the highest rate of health insurance coverage of any state in the country. The program has widespread popular support, and it served as a model for the design of President Obama's affordable care act, which established a plan for mandatory coverage on a national basis for the first time in the United States. This report will briefly describe the reform and its context, but will focus for purposes of simplicity on the operational details of the mass health program of health insurance for the poor. A discussion of the administration and management of Mass Health can offer a glimpse into the inner workings of all other insurance plans in the commonwealth. Mass health, private insurance, and Commonwealth Care share similar tools, controls, and strategies.