Qatar funding model review

National Health Insurance Company of Qatar, 2013

Health Policy Analysis participated in an international consortium advising the National Health Insurance Company of Qatar and the Qatar Supreme Council of Health on the pricing of payments under Stage 2 of the National Health Insurance Scheme of Qatar (known as Seha). Jim Pearse from Health Policy Analysis was the project leader for the consortium, and Health Policy Analysis undertook the major part of the consultancy. Stage 2 involved a significant expansion of the scheme to all Qatari nationals and all services, from a limited coverage of maternity and gynaecology services in stage 1. The project was performed under extremely tight deadlines, and the national interest in the scheme was high. The project commenced at the beginning of February 2014 and the price schedules were released by 30 April 2014. The consultancy continued through to October 2014, involving further refinement of the price schedules and the payment rules developed.

Prices and payment rules were developed for the following areas: The resulting price schedule for Seha contains prices and business rules for a comprehensive range of services, including:

To develop the price lists and payment rules, Health Policy Analysis undertook consultations with the major public and private health care providers in Qatar, analysed local cost data and local prices (from private providers), and undertook benchmarking of the local costs and prices with those from international systems.

Also delivered as part of the consultancy were training webinars for local providers on the classification systems used and the payment rules, and a software application for the National Health Insurance Company to model the impact of various policy decisions.