[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-108365-en":3,"doc-seo-108365-105":30,"detail-sidebar-cat-0-en-105":92},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":20,"is_deleted":4,"is_public":21,"is_downloadable":21,"audit_status":21,"page_count":22,"language":23,"language_code":24,"site_id":25,"html_lang":24,"table_of_contents":26,"faqs":27,"seo_title":13,"seo_description":14,"update_tm":28,"read_time":29},108365,4810365810221,"Aurora","https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d",8,"Research & Report","Advancing health financing reforms toward universal health coverage in Kosovo","Advancing health financing reforms toward universal health coverage (UHC) in Kosovo examines how health financing arrangements shape revenue generation, risk pooling, and purchasing of services and medicines. It explains that despite plans for free or low user-fee care, limited availability leads to substantial out-of-pocket payments, worsening income inequalities. The report identifies low and insufficient public spending, gaps in risk pooling, and lack of strategic purchasing—along with missing decisions on benefit packages, contracting, and provider payment—then presents policy directions and next steps to improve UHC outcomes.","Pub lic Disclosure Authorized Pub lic Disclosure Authorized Pub lic Disclosure Authorized Pub lic Disclosure Authorized  \nWORLD BANK GROUP  \nAdvancing health financing reforms toward universal health coverage in Kosovo  \nHaThi Hong Nguyen, Tihomir Strizrep, Daniel Prinz, MrikeAliu  \nSeptember 2023  \nWORLD BANK GROUP  \nAdvancing health financing reforms toward universal health coverage in Kosovo  \nSeptember 2023  \nContents  \nExecutive Summary 6  \n1. Introduction 9  \n1.1. Advancing health financing reforms to contribute to universal health coverage goals 9  \n1.2. The link between health financing and UHC 10  \n2. Health and health financing in Kosovo 12  \n2.1. Overview 13  \n2.2. Resource mobilization and health spending 15  \n2.3. Risk pooling 18  \n2.4. Strategic purchasing 19  \n3. Shortcomings in UHC goals associated with health financing arrangements 22  \n3.1. Insufficient public spending causes input constraints, poor access,  \nand low quality of care 23  \n3.2. Absence of strategic purchasing contributes to inefficiency 26  \n3.3. Lack of effective pooling and a guaranteed benefit package  \nnecessitates high OOP payments and imposes financial risk on the population 27  \n4. Advancing health financing reforms toward UHC goals  \noverall directions and next steps: policy recommendations 28  \n4.1. Introducing strategic purchasing and provider-payer split 29  \n4.2. Introducing a targeting mechanism for exemption in social programs  \nto ensure fairness and fiscal sustainability 32  \n4.3. Instituting an effective national risk pool 32  \n4.4. Considerations for mobilizing additional resources for health 33  \n4.5. Concrete short-and medium-term measures to develop capacity  \nfor strategic purchasing and risk pooling 35  \nPiloting the management of the Outpatient Drug Benefit Package  \n(ODBP) by the HIF 36  \nIntroduction of contracting and case-based payment for treatment  \noutside the public sector 37  \nGradually expanding performance-based capitation payment building on the experience of the KHP 37  \nReferences 38  \nAnnex: Global good practices in health financing 41  \nRevenue generation 41  \nPooling 42  \nPurchasing 43  \n4   \nThis report was prepared by Ha Thi Hong Nguyen (Senior Economist), Tihomir Strizrep (Consultant), Daniel Prinz (Economist), and Mrike Aliu (Human Development Specialist) . The team gratefully acknowledges guidance and comments from Tania Dmytraczenko (Practice Manager, Health, Nutrition and Population, Europe and Central Asia), Massimiliano Paolucci (Country Manager for Kosovo and North Macedonia), Ajay Tandon (Lead Economist), Marvin Plötz (Senior Economist), the Ministry of Health, the Board of the Health Insurance Fund, and participants of the Round Table on Advancing Health Reforms toward Universal Health Coverage on March 20, 2023, in Pristina, Kosovo. Richard Crabbe provided editorial services.  \nThis report was originally published as part of the 2023 Kosovo Public Expenditure Review. The Swiss Agency for Development and Cooperation provided partial funding to this work.  \nThe report is a product of the staff of the World Bank Group. The findings, interpretations, and conclusions expressed in this report do not necessarily reflect the views of the Executive Directors of the World Bank (or the governments they represent), or the Government of the Republic of Kosovo.  \nExecutive Summary  \n1. Achieving improved health outcomes through fiscal spending would enhance human capital in Kosovo. The country lags peers in terms of amounts allocated for healthcare and on the effectiveness of public spending to improve health outcomes, reflected in weaker health outcomes compared to peers.  \n2. Appropriate health financing arrangements can promote progress towards universal health coverage (UHC). Simply, UHC means that all people have access to the health services they need, when and where they need them, and without causing financial hardship. Health financing arrangements are important in achieving UHC because they define","cbCais1e674g2PwI","https://ap.wps.com/l/cbCais1e674g2PwI","pdf",2032893,6,1,48,"English","en",105,"# Executive Summary\n# Introduction\n## Advancing health financing reforms to contribute to universal health coverage goals\n## The link between health financing and UHC\n# Health and health financing in Kosovo\n## Overview\n## Resource mobilization and health spending\n## Risk pooling\n## Strategic purchasing\n# Shortcomings in UHC goals associated with health financing arrangements\n## Insufficient public spending causes input constraints, poor access, and low quality of care\n## Absence of strategic purchasing contributes to inefficiency\n## Lack of effective pooling and a guaranteed benefit package necessitates high OOP payments\n# Advancing health financing reforms toward UHC goals overall directions and next steps: policy recommendations\n## Introducing strategic purchasing and provider-payer split\n## Introducing a targeting mechanism for exemption in social programs\n## Instituting an effective national risk pool\n## Considerations for mobilizing additional resources for health\n## Concrete short- and medium-term measures to develop capacity","[{\"question\":\"What does universal health coverage mean in this report?\",\"answer\":\"UHC means everyone can access the health services they need, when and where they need them, without suffering financial hardship.\"},{\"question\":\"Why are health financing arrangements central to progress toward UHC in Kosovo?\",\"answer\":\"They determine how revenue is generated for health services, how risks and costs are pooled across people, and how services and goods are purchased.\"},{\"question\":\"What are the main health financing shortcomings linked to UHC goals?\",\"answer\":\"Insufficient public spending contributes to input constraints, poor access, and low quality; strategic purchasing is lacking; and limited pooling and a guaranteed benefit package increase out-of-pocket payments and financial risk.\"}]",1784470694,121,{"code":4,"msg":31,"data":32},"ok",{"site_id":25,"language":24,"slug":33,"title":13,"keywords":34,"description":14,"schema_data":35,"social_meta":87,"head_meta":89,"extra_data":91,"updated_unix":28},"advancing-health-financing-reforms-toward-universal-health-coverage-in-kosovo","",{"@graph":36,"@context":86},[37,54,69],{"@type":38,"itemListElement":39},"BreadcrumbList",[40,44,48,51],{"item":41,"name":42,"@type":43,"position":21},"https://docshare.wps.com","Home","ListItem",{"item":45,"name":46,"@type":43,"position":47},"https://docshare.wps.com/document/","Document",2,{"item":49,"name":12,"@type":43,"position":50},"https://docshare.wps.com/document/research-report/",3,{"item":52,"name":13,"@type":43,"position":53},"https://docshare.wps.com/document/advancing-health-financing-reforms-toward-universal-health-coverage-in-kosovo/108365/",4,{"url":52,"name":13,"@type":55,"author":56,"headline":13,"publisher":58,"fileFormat":61,"inLanguage":24,"description":14,"dateModified":62,"datePublished":63,"encodingFormat":61,"isAccessibleForFree":64,"interactionStatistic":65},"DigitalDocument",{"name":9,"@type":57},"Person",{"url":41,"name":59,"@type":60},"DocShare","Organization","application/pdf","2026-07-31","2026-07-19",true,{"@type":66,"interactionType":67,"userInteractionCount":20},"InteractionCounter",{"@type":68},"ViewAction",{"@type":70,"mainEntity":71},"FAQPage",[72,78,82],{"name":73,"@type":74,"acceptedAnswer":75},"What does universal health coverage mean in this report?","Question",{"text":76,"@type":77},"UHC means everyone can access the health services they need, when and where they need them, without suffering financial hardship.","Answer",{"name":79,"@type":74,"acceptedAnswer":80},"Why are health financing arrangements central to progress toward UHC in Kosovo?",{"text":81,"@type":77},"They determine how revenue is generated for health services, how risks and costs are pooled across people, and how services and goods are purchased.",{"name":83,"@type":74,"acceptedAnswer":84},"What are the main health financing shortcomings linked to UHC goals?",{"text":85,"@type":77},"Insufficient public spending contributes to input constraints, poor access, and low quality; strategic purchasing is lacking; and limited pooling and a guaranteed benefit package increase out-of-pocket payments and financial risk.","https://schema.org",{"og:url":52,"og:type":88,"og:title":13,"og:site_name":59,"og:description":14},"article",{"robots":90,"canonical":52},"index,follow",{"doc_id":7,"site_id":25},{"code":4,"msg":5,"data":93},[94,98,102,106,111,115,120,123,128,131,135],{"id":21,"doc_module":4,"doc_module_name":46,"category_name":95,"show_sort_weight":96,"slug":97},"Story & Novel",90,"story-novel",{"id":47,"doc_module":4,"doc_module_name":46,"category_name":99,"show_sort_weight":100,"slug":101},"Literature",80,"literature",{"id":53,"doc_module":4,"doc_module_name":46,"category_name":103,"show_sort_weight":104,"slug":105},"Exam",70,"exam",{"id":107,"doc_module":4,"doc_module_name":46,"category_name":108,"show_sort_weight":109,"slug":110},5,"Comic",60,"comic",{"id":20,"doc_module":4,"doc_module_name":46,"category_name":112,"show_sort_weight":113,"slug":114},"Technology",50,"technology",{"id":116,"doc_module":4,"doc_module_name":46,"category_name":117,"show_sort_weight":118,"slug":119},7,"Healthcare",40,"healthcare",{"id":11,"doc_module":4,"doc_module_name":46,"category_name":12,"show_sort_weight":121,"slug":122},30,"research-report",{"id":124,"doc_module":4,"doc_module_name":46,"category_name":125,"show_sort_weight":126,"slug":127},9,"Religion & Spirituality",20,"religion-spirituality",{"id":126,"doc_module":4,"doc_module_name":46,"category_name":129,"show_sort_weight":126,"slug":130},"World Cup","world-cup",{"id":132,"doc_module":4,"doc_module_name":46,"category_name":133,"show_sort_weight":132,"slug":134},10,"Lifestyle","lifestyle",{"id":136,"doc_module":4,"doc_module_name":46,"category_name":137,"show_sort_weight":107,"slug":138},19,"General","general"]