Provider payment methods and purchasing arrangements promote quality of care and coordination across levels of care

National Hospital Insurance Fund (NHIF)

To a limited extent. Capitation payment implementation hampered by poor provider involvement, lack of clarity in populations linked to facilities, poor information sharing and low levels of payment overall. Payment systems, contracting systems and service delivery requirements do not encourage coordination across levels of care

National Government (Ministry of Health MOH)

To a limited extent.  Salaries may enhance quality of care by not incentivizing overuse. Line item budgets, on the other hand, are difficult to link to quality requirements. Weaknesses in standard setting and enforcement may undermine quality

County Governments (County Departments of Health CDOH)

To a limited extent. Public sector  coordination across levels of care remains weak owing to challenges with information systems, poor linkage of individuals to primary care providers, and weakness in referral mechanisms. Salaries may enhance quality of care by not incentivizing overuse. Line item budgets, on the other hand, are difficult to link to quality requirements. Weaknesses in adherence to clinical guidelines and other standards may undermine quality especially in the absence of enforcement

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