DESIGN ELEMENT 8: MONITORING AND EVALUATION OF HEALTH INSURANCE SCHEMES

1. DESIGN ELEMENT 8:MONITORING AND EVALUATION OF HEALTH INSURANCE SCHEMES Hong Wang, MD, PhD HS202 project October 19-23

2. Figure 1: Design Elements for a Health Insurance Scheme Feasibility of Insurance Design and Implementation Insurance Financing options Population coverage Benefits package Provider engage-ment Organiza- tional structure Opera-tional process Monitoring and Evaluation

3. Objectives of this element • Be familiar with indicators that scheme operators, managers, and evaluators can use to assess the performance of an insurance scheme to evaluate the achievement of its desired objectives • Understand sources of data for M&E of insurance schemes • Know how to use information to make evidence-based decisions to improve the performance of a health insurance scheme

5. Types of M&E • Monitoring • Continues efforts that rely on the information system (element 7) • Focus more on input, process, and output measurements and some of outcome indicators. • Enrollments • Reimbursements • Financial performances • Utilization and financial burden reduction

6. Types of M&E • Evaluation: Focus more on outcome and impact • Cross sectional without control Health insurance Intervention group A2 Control group

7. Types of M&E • Evaluation • Case control without baseline Health insurance Intervention group A2 Control group B2

8. Types of M&E • Evaluation • Pre-post without control Health insurance Intervention group A1 A2 Control group

9. Types of M&E • Evaluation • Pre-post with control – social experimental design Health insurance Intervention group A1 A2 Control group B2 B2

10. Types of M&E • Evaluation • Experimental design Random assignment Health insurance Intervention group A1 A2 Control group B2 B2

11. Thank you