Table 4. Budgetary transfers Key features International practice Vietnamese practice Budget calculation -Budgets based on inputs (the Based on input norms: either least advisable) number of beds, number of -Budgets based on projected staff volume of services (more acceptable) -Budgets based on catchment area and population or other proxies for health care needs (the most advisable) Cost items Budget excludes some cost Budget excludes some cost items items Fund holding If there is fund holding, the -Health centres and district rules of payment to providers hospitals hold budgets for should be transparent, and commune health stations providers should not be at rules are –Payment greater financial risk than transparent they are able to manage -Providers are at greater financial risk than they are able to manage Payment Caps, Deficits and -There is a hard budget cap -Payment caps are used for Surpluses and overruns are carefully reimbursement of primary managed and controlled health care facilities and for -Providers are allowed to reimbursement of referrals keep a portion of surpluses, -Autonomous health care with financial accountability providers are allowed to keep for its use surplus and use it in accordance with Decree 16/2015/ND-CP - Managers of health care facilities are responsible for managing and controlling the balance of revenues and expenditures Budget allocation Standardized procedures with Standardized procedures with no delay in payment occasional delay in payment Key positive features of the budgetary transfers are: it is predictable for the fund holder; it permits more efficient use of resources, but gain in efficiency depends how resources are managed;
Table 4. Budgetary transfers Key features International practice Vietnamese practice Budget calculation -Budgets based on inputs (the least advisable) -Budgets based on projected volume of services (more acceptable) -Budgets based on catchment area and population or other proxies for health care needs (the most advisable) Based on input norms: either number of beds, number of staff Cost items Budget excludes some cost items Budget excludes some cost items Fund holding If there is fund holding, the rules of payment to providers should be transparent, and providers should not be at greater financial risk than they are able to manage -Health centres and district hospitals hold budgets for commune health stations –Payment rules are transparent -Providers are at greater financial risk than they are able to manage Payment Caps, Deficits and Surpluses -There is a hard budget cap and overruns are carefully managed and controlled -Providers are allowed to keep a portion of surpluses, with financial accountability for its use -Payment caps are used for reimbursement of primary health care facilities and for reimbursement of referrals -Autonomous health care providers are allowed to keep surplus and use it in accordance with Decree 16/2015/ND-CP - Managers of health care facilities are responsible for managing and controlling the balance of revenues and expenditures Budget allocation Standardized procedures with no delay in payment Standardized procedures with occasional delay in payment Key positive features of the budgetary transfers are: it is predictable for the fund holder; it permits more efficient use of resources, but gain in efficiency depends how resources are managed;
9.%20Report%20on%20PPM%20mix%20EN.docx