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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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Philippines’ Government Sponsored Health Coverage Program for Poor HouseholdsThis is a nuts and bolts case study of the implementation of the government-financed health coverage program (HCP) for poor households in the Philippines. The data and information in this case study largely draws upon the 2011 World Bank Report 'Transforming the Philippine health sector: challenges and Future Directions' (Chakraborty et al. 2011), and technical work undertaken for World Bank support to the Government of the Philippines (GOP) for universal health coverage (UHC) in the Philippines.2 The aim of the case study is to understand how the HCP was implemented, what worked and did not work, and how it impacted expected results under the HCP. In 1996, similarly to many low- and middle-income countries, the Philippines introduced a demand-side program for poor households (the Sponsored Program). The objective was to improve access of poor households to needed health services without experiencing a financial burden. Unlike many countries, where such programs are stand alone, in the case of the Philippines it was integrated into the National Health Insurance Program (NHIP). This is a sound design feature from the perspective of providing optimal risk pooling and redistribution, and the Philippines is a model for other countries implementing similar schemes for poor households. The national government has included financing for poor households in the medium-term national expenditure program, so there is no danger of uncertainty in financing. PhilHealth is incrementally strengthening its contract implementation and monitoring mechanisms. The main challenge now facing the HCP is whether these revamped efforts will be able to quickly address the problem of lack of access to quality and affordable services for poor households. There are supply side constraints, facilities will need to be upgraded to obtain Philhealth accreditation. Accredited health facilities will have to be held accountable for delivering services and where public services are not available, mechanisms for incentivizing the private sector for outreach to poor households will have to be deployed. Much depends on Phil Health's capacity as an effective purchaser of health services. Local government unit (LGU) facility capacity to respond to revamped PhilHealth incentives is another bottleneck. The other challenge is whether the Department of Health and PhilHealth will be able to quickly build the monitoring and evaluation systems needed to track HCP implementation and make the necessary in-flight adjustments in implementation in a timely manner.