Public Stewardship of Private Providers in Mixed Health Systems

Synthesis report from the Rockefeller Foundation—sponsored initiative on the role of the private sector in health systems

Drawing extensively on the findings of a 2008 review sponsored by the Rockefeller Foundation (resulting in 14 reports) and on the vast other literature on the private health sector and health systems, this report by authors from the Results for Development Institute and the Rockefeller Foundation, outlines the large and complex private markets for healthcare and emphasizes the importance of effective public stewardship by governments of their country’s health system, especially given the reality that the private (non-state) part of the system is large and complex, with major challenges and significant opportunities. The report suggests three types of policies for better public stewardship of mixed health systems:

  • Regulatory policies that monitor quality effectively and mitigate the worst health market failures.
  • Financing policies that minimize out-of-pocket payments and increase access by pooling risks across populations with subsidies for the poor.
  • Purchasing policies that create incentives for quality and for delivering high-impact interventions and services to the poor.

The report also discusses three ideas for accelerating progress toward better stewardship of mixed health systems:

  • Investing in information about health markets.
  • Supporting innovative models that can serve as “stepping stones” to broader reforms.
  • Developing a roadmap for mixed health system stewardship.

For more information on the synthesis report feel free to contact the authors.

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