Price Setting and Price Regulation in Health Care: Lessons for Advancing Universal Health Coverage. Geneva: World Health Organization, Organisation for Economic Co-Operation and Development; 2019
(2019; 100 pages)


This study was carried out to support countries in meeting international commitments towards Universal Health Coverage. It aims to gather experiences in price setting and regulation, generate best practices, and identify areas for future research. There is a special focus on the implications for middle-income settings, which represent more than 70% of the world’s population. The share of public spending on health in these settings doubled between 2000 and 2016. This increase in public spending has been accompanied by new ways of financing, organizing, and delivering health care. A key question is how to make use of all health resources – from both private and public sources – to attain health-related goals.

Health care is far from being a classic market for goods and services. Individuals are usually represented by a purchasing agent (i.e., health insurers) instead of operating by themselves, and do not have complete information. This makes people less sensitive to prices. However, prices provide important signals to health care providers, given that they determine the level of financial resources to deliver health care services.

Provider payment systems consist of one or more payment methods and their supporting systems such as contracting and reporting mechanisms, which are used to create economic signals and incentives that influence behaviour. Any payment method has three dimensions: the base upon which prices are defined and set; the level of payment per unit of the chosen base; and the administrative and economic process by which that price level is determined. This study focuses on these key dimensions.

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