JANUARY

Recommendations

Info

ISRAEL • Using electronic health records effectively, particularly in the community • Purchasing pharmaceuticals in bulk and relying heavily on generics • Setting maximum hospital reimbursement rates (government), negotiating discounts (health plans), and instituting hospital global revenue caps • Explicitly prioritizing public funding for new technologies included in the NHI benefits package • Aligning organizational and financial incentives between clinicians and the hospitals or health plans for whom they work (see below). Although clinicians are rarely given explicit financial incentives to contain costs, reliance on salary and capitation (rather than fee-for-service) may reduce incentives to over-treat. Moreover, the health plans have various internal processes to discourage care that provides poor value. Of recent concern to some experts, however, is the recent growth of private medical care and private financing, which is seen as potentially jeopardizing Israel’s success in containing cost growth. What major innovations and reforms have been introduced? Mental health: In July 2015, mental health care was added to the set of services that the health plans must provide within the NHI framework, making access a legally guaranteed right rather than a government-supplied service whose availability is subject to budget constraints. Because of this new mandatory package of mental health services, government funding for health plans has been increased substantially to cover the additional costs. The main objectives of the reform are to improve the linkage between physical and mental care, increase the availability of mental health services, and increase efficiency. An external evaluation will ascertain the extent to which the objectives are achieved and whether various concerns are realized (Rosen et al., 2008). Comparative data on hospital performance: In 2015, the MoH began publishing comparative data on hospital quality, and there are plans to rapidly expand the indicator set in the years ahead. In 2014, the Ministry published the results of a nationwide survey of hospitalized patients regarding their care experience. It is also assembling a database of waiting times for surgical operations, with the intention of publishing comparative data in 2016. The objectives of all these efforts are to provide hospitals with information to help identify problem areas, enhance consumer choice of hospitals, and provide hospitals with incentives to improve performance. Reducing surgical waiting times: Long waiting times are perceived as one of the major causes of the recent growth in private financing and care provision. Motivated by a desire to improve public confidence in the publicly financed health care system as well as quality of care, the MoH is planning a major initiative to reduce surgical waiting times. This will involve additional funding to expand hours of operation for surgical theaters as well as a series of organizational changes to improve efficiency. Improving service levels in hospital EDs: As part of a broader effort to improve patient-centered care and service levels, the MoH is launching a major effort to reduce waiting times between patient arrival and the first contact with a health care professional. Strategies are to include enhanced physician, nurse, and physician assistant staffing, as well as engaging operations management experts to improve workflow. Long-term care insurance: Israel’s long-term care system is seriously fragmented, with service gaps, duplication of care, inefficient incentives, and inadequate investment in prevention and rehabilitation. The government is working on a plan to add institutional long-term care to the set of NHI benefits for which the health plans are responsible, with the plans also serving as the budget holders for institutional LTC. 94 The Commonwealth Fund
ISRAEL This profile draws on the forthcoming Healthcare in Transition—Israel, by Bruce Rosen, Ruth Waitzberg, and Sherry Merkur, due to be published in early 2016 by the European Observatory on Health Systems and Policies. The profile also benefited from valuable input from Martin Wenzl of the London School of Economics and Political Science. References Asiskovitch, S. “The Long-Term Care Insurance Program in Israel: Solidarity with the Elderly in a Changing Society.” Israel Journal of Health Policy Research, Jan. 23, 2013 2(1):3. Balicer, R. D., M. Hoshen, C. Cohen-Stavi, S. Shohat-Spitzer, C. Kay, H. Bitterman, N. Lieberman, O. Jacobson, E. Shadmi (2015). “Sustained Reduction in Health Disparities Achieved Through Targeted Quality Improvement: One-Year Follow-Up on a Three-Year Intervention.” Health Services Research, March 19, 2015. E-pub ahead of print. Bentur, N., L. L. Emanuel, N. Cherney. “Progress in Palliative Care in Israel: Comparative Mapping and Next Steps.” Israel Journal of Health Policy Research, Feb. 20, 2012 1(1):9. Brammli-Greenberg, S., T. Medina-Artom (2015). Public Opinion on the Level of Service and Performance of the Healthcare System in 2014. Jerusalem: Myers-JDC-Brookdale Institute. Brammli-Greenberg, S., R. Waitzberg, V. Perman, R. Gamzu (forthcoming). “How Israel Reimburses Hospitals Based on Activity: The Procedure-Related Group (PRG) Incremental Reform.” OECD Publishing. Brammli-Greenberg, S., R. Waitzberg, R. Gross (2015). “Integrating Private Insurance into the Israeli Health System: An Attempt to Reconcile Conflicting Values.” In S. Thomson, E. Mossialos (eds.), Private Health Insurance and Medical Savings Accounts: History, Politics, Performance. Cambridge, England: Cambridge University Press. Greenberg, D., M. I. Siebzehner, J. S. Pliskin (2009). “The Process of Updating the National List of Health Services in Israel: Is It Legitimate? Is It Fair?” International Journal of Technology Assessment in Health Care, July 2009 25(3):255–61. Haklai, Z. (2014). Inpatient Institutions and Day Care Units in Israel—2013. Jerusalem, Ministry of Health. Intel (2015). “Improving Health Outcomes and Reducing Costs with Video Conferencing Technology.” Jaffe, D. H., A. Shmueli, A. Ben-Yehuda, O. Paltiel, R. Calderon, A. D. Cohen, E. Matz, J. K. Rosenblum, R. Wilf-Miron, O. Manor (2012). “Community Healthcare in Israel: Quality Indicators 2007–2009.” Israel Journal of Health Policy Research 1(1):3. Rosen, B., N. Niral, R. Gross, S. Bramali, N. Ecker (2008). “The Israeli Mental Health Insurance Reform.” Journal of Mental Health Policy and Economics, Dec. 2008 11(4):201–08. Rosen, B., L. G. Pawlson, R. Nissenholtz, J. Benbassat, A. Porath, M. R. Chassin, B. E. Landon (2011). “What the United States Could Learn from Israel About Improving the Quality of Health Care.” Health Affairs, April 2011 30(4):764–72. Rosen, B., R. Waitzbeg, S. Merkur (forthcoming). “Israel: Health System Review.” Health Systems in Transition. Rosen, B. (2012). “Inclusion of Dental Care for Children in NHI.” Health Systems and Policies Platform. International Profiles of Health Care Systems, 2015 95
Page 1 and 2:
JANUARY 2016 2015 International Pro
Page 3:
2015 International Profiles of Heal
Page 6 and 7:
Table 1. Health Care System Financi
Page 8 and 9:
Table 3. Selected Health System Per
Page 11 and 12:
The Australian Health Care System,
Page 13 and 14:
AUSTRALIA low-income adults, childr
Page 15 and 16:
AUSTRALIA In 2013, the federal gove
Page 17 and 18:
What is being done to reduce dispar
Page 19:
References AUSTRALIA Australian Bur
Page 22 and 23:
CANADA What is covered? Services: T
Page 24 and 25:
CANADA funding to 145 not-for-profi
Page 26 and 27:
CANADA Organization of the Health S
Page 28 and 29:
CANADA provides recommendations to
Page 30 and 31:
CANADA Health Council of Canada (20
Page 32 and 33:
CHINA Private health insurance: Com
Page 34 and 35:
CHINA is not substantially more exp
Page 36 and 37:
CHINA Organization of the Health Sy
Page 38 and 39:
CHINA References Chen, X. (2014).
Page 40 and 41:
DENMARK In addition, nearly 1.5 mil
Page 42 and 43:
DENMARK Social psychiatry and care
Page 44 and 45: DENMARK Quality data for a number o
Page 46 and 47: DENMARK portion is small, it makes
Page 48 and 49: 48
Page 50 and 51: ENGLAND immunization, and vaccinati
Page 52 and 53: ENGLAND Hospitals: Publicly owned h
Page 54 and 55: ENGLAND Organization of the Health
Page 56 and 57: ENGLAND How are costs contained? Ra
Page 58 and 59: ENGLAND Organisation for Economic C
Page 60 and 61: FRANCE VHI finances 13.8 percent of
Page 62 and 63: FRANCE The average income of primar
Page 64 and 65: FRANCE What are the key entities fo
Page 66 and 67: FRANCE inequities in prevention rel
Page 68 and 69: FRANCE Nolte, E., C. Knai, and M. M
Page 70 and 71: GERMANY There were 42 substitutive
Page 72 and 73: GERMANY The 16 state governments de
Page 74 and 75: GERMANY management system, by the s
Page 76 and 77: GERMANY What major innovations and
Page 78 and 79: INDIA Private health insurance: The
Page 80 and 81: INDIA provide after-hour care, reim
Page 82 and 83: INDIA are provided by other ministr
Page 84 and 85: INDIA How are costs contained? Ther
Page 86 and 87: 86
Page 88 and 89: ISRAEL Together, these two types of
Page 90 and 91: ISRAEL Primary care physicians are
Page 92 and 93: ISRAEL Organization of the Health S
Page 96 and 97: 96
Page 98 and 99: ITALY during hospitalization (Thoms
Page 100 and 101: ITALY Some regions are promoting ca
Page 102 and 103: ITALY Organization of the Health Sy
Page 104 and 105: ITALY although the degree of evolut
Page 106 and 107: ITALY The author would like to ackn
Page 108 and 109: JAPAN What is covered? Services: Al
Page 110 and 111: JAPAN incentives for providers to c
Page 112 and 113: JAPAN Organization of the Health Sy
Page 114 and 115: JAPAN The author would like to ackn
Page 116 and 117: THE NETHERLANDS receive faster acce
Page 118 and 119: THE NETHERLANDS Hospital payment ra
Page 120 and 121: THE NETHERLANDS Organization of the
Page 122 and 123: THE NETHERLANDS References Organisa
Page 124 and 125: NEW ZEALAND provided in GP clinics.
Page 126 and 127: NEW ZEALAND management (e.g., clean
Page 128 and 129: NEW ZEALAND including such informat
Page 130 and 131: NEW ZEALAND largely through efficie
Page 132 and 133: 132
Page 134 and 135: NORWAY Primary, preventive, and nur
Page 136 and 137: NORWAY Patients are free to choose
Page 138 and 139: NORWAY What are the major strategie
Page 140 and 141: NORWAY The National System for the
Page 142 and 143: 142
Page 144 and 145:
SINGAPORE Medifund is the governmen
Page 146 and 147:
SINGAPORE Public hospital funding i
Page 148 and 149:
SINGAPORE Public consultation: The
Page 150 and 151:
SINGAPORE To keep demand for servic
Page 152 and 153:
152
Page 154 and 155:
SWEDEN What is covered? Services: T
Page 156 and 157:
SWEDEN Hospitals: There are seven u
Page 158 and 159:
SWEDEN Care, which promotes use of
Page 160 and 161:
SWEDEN What major innovations and r
Page 162 and 163:
SWITZERLAND Insurers offer premiums
Page 164 and 165:
SWITZERLAND Hospitals: About 70 per
Page 166 and 167:
SWITZERLAND Organization of the Hea
Page 168 and 169:
SWITZERLAND To control pharmaceutic
Page 170 and 171:
170
Page 172 and 173:
UNITED STATES What is covered? Serv
Page 174 and 175:
UNITED STATES Administrative mechan
Page 176 and 177:
UNITED STATES The Institute of Medi
Page 178 and 179:
UNITED STATES adopted at least a ba
Page 180:
The COMMONWEALTH FUND Affordable, q
show all

JANUARY

Create successful ePaper yourself

Delete template?

Save as template?