importance in the effective management of the project

Bastgragaha for a very long time in processing up for years in some cases, as was the result in action inconsistent decisions and duplication of effort during the evaluation of claims and processing. Emergency program included to support the implementation of social protection to develop an automated system to manage claims aim internal clinics in hospitals claims management. Offering electronic claims from hospitals and then be processed automatically, with proper supervision, and then issued a letter adoption of repayment. And it included the development process to conduct numerous interviews and workshops with the National Social Security Fund staff to determine the workflow procedures as well as the valuation rules of the National Social Security Fund, with extensive participation to the end user is one of the key features of this project, and has been integrated into the evaluation rules in the “engine rules “he automatically applied to each of the claims, and completed the pilot program, which was attended by three hospitals in 2009.
221. drew a number of lessons learned from this program, including: (a) In addition to the formation of a project team to manage the claims, the National Social Security Fund had already contracted with the IT service provider to complete other related work. It was clear that a successful interaction between the teams a very important factor, and that was difficult to achieve at times. It is crucial that the implementation body coordination between all the teams that do business related to each other. And it is of the utmost importance in the effective management of the project as a whole. (B) There have been times when obstructed maintain the project within the specified scope. Technical issues have appeared seemingly separate but linked with each other, it was necessary to be addressed to ensure the system performance of their functions in the end. (C) must implement fully prepared for delivery gradual and final products for the body. It must be of sufficient funds and staff and training is available for the effective transfer of skills and technology enabled.
222. Slovenia. Health sector Slovenian management project started in 2000 to support a large variety of areas, including health policy, and the development of health standards, and health information systems support included the establishment of a national mechanism for the exchange of health information and be a central hub for the exchange of information on health matters between the bodies. Generally it has been evaluated in the project outcomes as satisfactory.
223. It turned out early in the project in relation to specific issues pertaining to the components of information systems that are not likely to accept the stakeholders of the concept of establishing a national mechanism for the exchange of information. It also emerged legal issues had to be addressed. UNU Institute of Public Health, for example, it was the only party allowed to legally review of health care outcomes data, complicating the task of health insurance body on categories of diagnostic classification system management. If the institute did not support an integrated information system full support, has slowed progress on the project. Therefore it was decided to reallocate some funding directed to the development of the field of information technology; to support other aspects of the project, such as the categories of diagnostic classification and quality of care, at a time when consultations will continue with stakeholders on the information system design. Then decide later in the 2003 follow-up to complete the establishment of data management would focus on the establishment of standards and procedures in order to improve data accuracy and to ensure the safety and confidentiality of the center. The centerpiece will be the initial focus is to support the classification categories of diagnostic program. The evaluation team was reached in this regard that where was an important IT project significantly components Vsachris then more time to understand the legal, institutional and political constraints, and then integrate this understanding into the project design process.
224. Summary expertise and international experience. One of the important lessons to be learned here from international experience is that it is difficult for the projects ambitious reform of health insurance systems that include components of information systems to comply with the timetable and budget agreed upon. In many cases that have been reviewed, some problems have arisen as a result of the widening scope of the project, which probably was not allowed to give sufficient attention to component information systems. One of the key lessons that have been applied in the development of the proposed health insurance systems in a project to determine the scope of the project unnecessary specifically very well and to be realistic, with a primary focus on the work system and technical requirements. Supervision of information technology and management of contractors as employees of their affairs is of paramount importance in ensuring the success of this project. It is likely to result in inadequate supervision of contractors to project failure. The lesson of this fundamental pillar for the inclusion of the project on the company assume the function of verification and validation in the framework of its core activities. The general level of participation has emerged as Body on Implementation of the concerns in some cases, where the high level of participation is crucial. It is also important to be consulted with a direct interest in all stages of this process, the owners, and that the current regulations to address developed to meet their needs, and that there is a steady flow of tools that will help them in their daily activities with the development of the project. It should be noted that in the Egyptian context, all of the General Authority for Health Insurance and the Ministry of Health is working closely with each other in order to create new social health insurance system. The minister personally oversee the change management effort, which represents Chairman of the General Authority for Health Insurance Administration the right arm and an assistant minister, are currently being implemented communication strategy and strong awareness regarding the various stakeholders. There is also a high-level effort to sift through a steering committee for health and social insurance system headed by the Prime Minister. In the end, one of the main sources of the delay is that information systems activities in the system design requirements and the procurement process is not implemented only after the adoption of the project or the date of entry into force. In the case of Health Insurance Systems Development Project, in charge of Egypt’s authorities have begun their work well in advance before the adoption of the project or the validity of its effective date Aftort strong technical systems requirements, and drafted brochures specification standard tenders and conditions, and launched the invitation process for the Request for Proposals already. It also expressed its desire to strengthen these pamphlets with advice provided by the Review Group on strengthening the quality of the technical specifications.

the clinical information system system in hospital

211. There is a positive constructive developments in the project which was implemented recently in some provinces such as Monofia in the context of health sector reform program, and will use them as building blocks in the new project.
• The health sector reform program is developing a series of contracting and payment tied to performance and implementation of systems, including primary health care premiums and categories of diagnostic classification systems for surgical patients in hospitals beneficiaries. And it is currently being evaluated formally those practical experiences in the framework of this program, and will take advantage of the results in the implementation of the new contract and payment and escalation and increase systems under the new social health insurance system.
• New systems will depend on good management information systems as well. Health sector reform program has been experimenting with a new clinical information system. It was run version 6 and version 7 in more than 300 units of family health in the provinces covered by the project (Alexandria, Menoufia) by the middle of 2007. According to the Ministry of Health that all units are fully equipped with all the necessary networks and equipment information technology. The final version is currently being tested at the central level in the Ministry of Health. It is necessary now to address two key issues: (1) lack of clinical information system to the forefront of touch with the information existing systems in family health funds, which is very important in the complete cycle of information in order to improve these funds service; and (2) the quality of data in care facilities health and completeness.
• it should also complement the clinical information system system in hospitals so that the benefits package covering health services provided by hospitals. It is clear, so far, of the indicators that the standard package of benefits (services) Stmathl closely approved the package in the General Authority for Health Insurance, a fully inclusive package. The clinical information system has been designed in order to allow the support of referral unit to function port (gate) model of family health, but the Ministry of Health and the General Authority for Health Insurance will that needed to develop referral protocols and tested for the adoption of the new system of social health insurance.
Lessons learned from the international experience
212. There are several examples of projects include programs to manage health information that allows lessons relevant, including: reform of the health insurance programs and widespread in Bulgaria and Slovenia, and the introduction of health management information system in Latvia, and the application of an automated system to manage claims in Lebanon. Of course, these projects are very different in terms of scope and size, but each of them is relevant to the proposed project.
213. Bulgaria. The health sector reform project in Bulgaria is extending the program for the past 5 years, was launched in 2000 with a loan from the International Bank for Reconstruction and Development, worth US $ 63 million, and the financing of government-peer amounted to US $ 24 million. He was a multi-faceted program, consist of the following key elements: (1) repair the units primary care hospitals, which included the supply of necessary equipment and devices, information systems, training and public awareness campaigns, and strategies to adapt labor conditions to deal with medical surplus labor; (2) national health insurance fund, which included ensuring the availability of adequate information and training systems for the Fund to be able to manage a national program for health insurance; (3) building the capacity within the health system, and specifically the national Health insurance Fund and the Health Ministry.
214. The overall assessment of the Bulgarian project outputs as reasonably satisfactory. As has been the administrative costs reduce national health insurance fund of more than 5 per cent in 2000 to about 2.6 per cent in 2008, as well as decreased the period of hospitalization from 11.5 days in 2000 to 6.5 days in 2008; while the number of installed information systems in units of primary care and hospitals from zero in 2000 to 4024 (primary care) and 154 (hospital) in 2008. factors that contributed to the success of the project: large government commitment to the initial reform process, and pre-analysis enormous by a variety of groups in order to determine the approach appropriate. The one aspect of the fundamental deficiencies, adopted in this project approach was ambitious unbridled nature of the project, with the implementation of many reform activities at one time.
215. The meaning of the project – with respect to component information systems of national health insurance fund – to build on the work of existing information contracted by the government by the technology. In fact, the contractors failed to deliver their product, resulting in a period of considerable delay of the project. And had to re-design the entire information system from scratch has not been launched definitively only in 2005, and did not complete integrated solution, but dropped in 2009. This prolongation in the duration of the project administrative burdens on the borrower and the World Bank. There is concern of sustainability steady information system, since the ownership of the project in the hands of the Ministry of Health is not in the National Health Insurance Fund grip, making it more difficult to create a maintenance and support contracts. This discontinuity in the process of developing the information system has led to the postponement of facilitating the establishment of disaster or the backup, which is what still needs to be addressed. Despite this, there was a feeling that the introduction of the information system is one of the most important achievements of the project.
216. Latvia. It was planned to be the development of management information system for the benefit of health insurance funds at a cost of 3.99 million US dollars, in the context of health reform project funded by the World Bank in Latvia and was introduced in 1999. In addition, it has been allocated US $ 969,200 from the grant free Agency Swedish international development. And it has had the purpose of the system that allows for decision-makers, medical and economic data they need, and can enter data, and make inquiries from service providers using a specially-developed package based on personal computers. Approach also included an international competitive tender to choose a contractor undertakes to complete a full work; in terms of delivery of all hardware and software required and installed, including the integration of existing equipment and provide training. The aim is planned to be operational management information system that leads the entire functions and then published in all parts of Latvia. Such as the establishment of a centralized system can handle 500 users at one time it has been identified specific technical requirements.
217. Implementation Completion Report 2004 reported that after the final signing of the contract in 2002, has been contracted to develop a management information system and the start of implementation, and the system is ready technically to receive all health information services paid for by the State. And continued implementation of the system and add new units.
218. been the development of management information system – in spite of it – for periods of significant delay, and it was felt that this great work is not appreciated enough appreciation. First Valmnaqsh delayed advertised for twelve months, due in part to that after the start of the project shortly, the Ministry of Transportation to conduct a review of the information technology activities at the government level entirely. There was also a lack of technical capacity within the Ministry of Social Solidarity, and delays related to international consultants. In order to keep the process of developing the management information system, it was felt should be the advancement of the Ministry of Health a stronger political backing, as well as support for public relations, conduct training, and supervision necessary.
219. relatively smooth implementation of this project and related projects, and other health information-funded management system from the World Bank – led to say a number of success factors critical: management and strong corporate governance, taking management structure of the exact account; and the structure of the contract and procedures for change management; and inputs professional to deepen specialized project experience; and proactive re-design of work processes; and the technical flexibility and sustainability, including the ability to adapt to a changing policy environment.
220. Lebanon. ESPISP began to apply the emergency program to support the implementation of social protection which is funded by the World Bank in 2007. It was among the groups core activities, Renewed National Social Security Fund, which is the largest national health insurance, particularly in the areas automate its claims management systems. The current regulations of the nature and characterized by a hand

Support supervision and implementation strategy

World Bank funds spent so far in preparation for the project:
1. World Bank resources: ~ US $ 450 403
2. Trust Funds: Policy and Human Resources Development ~ US $ 464 331
3. Total: ~ US $ 914 734

Estimated costs for accreditation and supervision:
1. The remaining cost of adoption: 60 thousand US dollars
2. The annual estimated cost of supervision: 200 thousand US dollars

Support supervision and implementation strategy
206. Articles of Association of the World Bank agreement requires that managers and staff bears responsibility for overseeing the implementation of the recipient of the projects and programs that receive funding from the World Bank. The main objective of supervision is to ensure that only the use of funding received in the intended purposes, paying due attention to economy and efficiency in spending, and ensure the achievement of support operations for their development objectives. In light of the complexity of the development of the proposed health insurance systems and attendant high-risk project, the World Bank proposes to apply the enhancer program for the supervision and implementation of the purpose of this project.
207. The following principles will guide this effort:
208. should be a supervising flexible and responsive, and serve as a mechanism for the continuation of the partnership. In this sense, supervision needs to be designed as a process of continuous and able to identify implementation challenges that arise in all aspects of the project and its rapid response interactive. Moreover, the the process that provides a mechanism for dialogue and close cooperation between the government and stakeholders. Thus, in addition to overseeing the functions of regular official semi-annual, Ministry of Health and the General Authority for Health Insurance and the World Bank have agreed to hold regular meetings every two weeks to assess the progress made and the issues that arise, and the areas that necessitate a united effort to ensure a coordinated solutions to common issues. To facilitate this ongoing interaction, the World Bank appointed head of a veteran staff and key members of the team in the field.
209. ensure that the provision of technical precision and approach based on team spirit is crucial given for each of the technical complexity and multiplicity of stakeholders for health insurance information systems that will be developed under the umbrella of the Health Insurance Systems Development Project. To respond effectively to the requirements of implementation; need supervision teams from both sides of the government and the World Bank both to be fitted Pachtsasian have the appropriate technical skills and expertise. This includes, among other things, technical specialists in the following areas: health insurance management systems and health insurance information, and purchase of complex information systems, economic analysis, institutional development, financial management and payments and communications. During the implementation it has shown the need for additional skills in order to deal with the emerging specific requirements.

 
Appendix 12: Documents project file
 The Egyptian Arabic Republic

Health Insurance Systems Development Project

210. Selected documents available to the World Bank and / or the Ministry of Health as follows:
Documents available to the World Bank and the Ministry of Health
• note dated May / May to June 9, 2008 27
• note dated 8 October / October 27, 2008
• note dated 12 May 18 / May 2009
• note dated 24 to October 29 / October 2009 (pre-assessment)
• Assess procurement capabilities, October / October 2009
• Assess the financial management capacity, in October / October 2009
• procurement plan for developing the health insurance systems October 28 / October 2009
• Japan, the Japanese Fund grant for policy development, human resources development, in May / May 29, 2007
Documents available to the Ministry of Health
• Management Information for health insurance and national specifications clinical information system providers system data flow, January 2007
• Technical report on the appropriate services outsourcing (BPO), November 2007
• assess the effects of family health insurance fund in Sohag, in July 2008 guide
• monitoring family health insurance, August / August 2008 Fund System Guide

The main mechanisms used to ensure the availability of economic justification

177. The main mechanisms used to ensure the availability of economic justification for the project include: device management reviews, audits and claims, and monitoring subscriptions, and inspections of clinical, screening and the main categories of claims service providers. Most of interventional procedures and reviews the relevant control and are today manually, a method is not only costly in time and human resources, but it is also likely that efficient in terms of costs with respect to returns. It will be the implementation of the Information Management System modern and efficient point of payment from doing these activities more effective manner. The main objectives with respect to sub-optimal use of resources and include the following: organized fraud and illegal acts of service providers and users, and behaviors of exaggerating the health services offered by service providers to maximize their income, which, poor medical practices. There are also other potential benefits, such as improving administrative efficiency and monitor adherence to the payment of contributions.
178. project investments – occur once fully implemented – impact on all areas that cause problems, as we discussed earlier. It is unrealistic in any case expect to solve all the problems completely, because many countries still enjoy much greater expertise in monitoring spending on health services suffer from these problems, albeit to a lesser degree.
a thousand. Manipulation, fraud and poor distribution of resources so the caller
179. There are different forms of manipulation, fraud and behaviors illegal ranging from business affect the entire system and colludes in which several members of both sides and users of service providers for the purpose of financial gain or get other benefits from the system and practices fraudulent service providers at the individual level in the range but it frequently is limited. It is also likely that there will be other types such as these behaviors, but the evidence of the practice of manipulation and fraud are not easily identifiable.
180. General Authority for Health Insurance has been able to present through revisions and manual checks computational claims submitted her from revealing the behavior of manipulation and fraud, such as claims for non-medical items. Despite the absence of further evidence methodology at the level of manipulation and fraud in Egypt for lack of a good system to provide management information, refer evidence from countries like the United States where there is also a fragmented health financing system to a large extent – that manipulation and fraud level in the billing It may range from 3 per cent to 10 per cent of total health care expenditures. In countries that have anti-manipulation and fraud programs are less developed significantly and information systems of lower quality and management, although it is the structure of health insurance by the regulations may vary but there are – beyond any doubt – manipulation and fraud and then poor distribution of financial resources, and perhaps they were approaching the level of the maximum estimated at 10 per cent.
181. The environment lacks a system for the management of claims electronically means that the anti-manipulation and fraud is one of the things that beset by problems, however, such a system along with the basic programs to combat manipulation and fraud should occur, an effective impact, since they may Ihbtan nearly 25 per cent manipulation of existing activities. And therefore making it difficult to confirm until the introduction of such electronic systems. Assuming that the potential for fraud percentage is 10 per cent of total health care expenditures, the resulting combination of claims management systems and software anti-manipulation and fraud, case work with them after three years, for example, for providing 2.5 per cent of total health care expenditures, or about 123 million dollars a year.
B. Exaggerating the health services offered by service providers to maximize their income by
182. percentage of service providers will actively looking for ways to manipulate their payment in excess of the entry system, based on the current and future nature of this system. Of course, this is to be expected, but if they are not combat it could lead to higher costs and then departs from that complies with best practices. It is difficult to assess the extent of these activities in Egypt because of the lack of data, but it is logical to assume that these activities may represent 10 per cent of total expenditure.
183. If our means to control such activities are in close and systematic monitoring of the process to take advantage of services and identify the emergence of behaviors are not acceptable, and then modifying the regulations and rules of repayment to curb these activities. We must make some effort in both operating and management information system, which will be provided through this project and the process of institutional capacity, which coincides with the work by the Egyptian government to Atsidia of this issue building. It is expected that this type of behavior that is resistant to change, but it is necessary to work to reduce these behaviors by about 20 per cent – the equivalent of 2 percent of total health care costs, or about $ 98 million annually.
Jim. Bad medical practices
184. The measure of good medical practice is extremely difficult for a number of reasons, including the disparity in the identification of best practices. The assessment of the health care technology – a special field to analyze the quality of health care, and the field to develop a standard policy for health care – is applied to a growing application in the OECD countries in the economic field. However, this assessment literally requires access to high quality data, which will be strengthened when developing project investments place of execution. Regardless of the lack of evidence in the beginning on the occurrence of medical errors in Egypt, it would be reasonable to conclude that 20 per cent at least a portion of all health costs related to medical treatments is not the best practice.
185. Judging by the evidence available at the international level on clinical practices and ways to address the glitches it is reasonable to assume that the combination of the information that will be provided through this project and the process of institutional capacity building and the development of programs that will be carried out by the Egyptian government system – will lead to reduce the financial impact of bad practices by 10 per cent, representing 2 per cent of total health care costs, or approximately $ 98 million annually.
D. Increase administrative efficiency
186. Evidence derived from different health care systems indicate that the administrative costs of health care can be high. For example, select a percentage of estimated administrative costs in the health system in the United States at 30 per cent. And it operates the fragmented nature of the system of the United States and the Egyptian regime – both – to pay these costs to increase as a result of what was happening in the past from economies of scale and duplication management systems. On the other hand, show evidence derived from systems with more compact purchasing systems bodies there are administrative costs that the general system of between 10 per cent and 12 per cent, much less than the fragmented systems.
187. The replacement of claims management system is based on the paper more efficient electronic system will lead to a significant reduction in cost per transaction – ideally less than one US dollar per claim. In addition, the introduction of links to service providers to enable them to file claims electronically to reduce the rate of rejection of claims, which is associated in the habit cost increase for the service provider to the point of payment will result.
188. difficult to determine line numbers for transaction costs and rates based on claims rejected because of the current system based on the use of paper documents and the organizational structure of the General Authority for Health Insurance that lead Doreen: hand payment service provider. However, it is possible to compare a new push anti-organized with or without use of management information system. At the international level, often the cost of processing paper claims is $ 7 per claim in exchange for almost one dollar to demand processed electronically. It is also reasonable to assume that the applicability of the relative difference in costs over Egypt. While acknowledging that the expected volume of claims outpatient clinics in Egypt is 460 million claims a year, it is clear that even then reduce the cost per transaction to US $ 1 will lead to the provision of US $ 460 million annually.
189. At a time when the potential savings in the administrative aspects associated with using a single purchaser of services is equipped with modern technologies trained cadre of managers and administrators – is a big saving and whatever, there are many factors that may limit the ability to achieve this administrative savings, such as the complexities involved in implementing the program organizational restructuring of this magnitude. Therefore, a very conservative estimate of the savings in the administrative aspects ranging from 1 per cent to 2 per cent of the total spending on health care services, or about US $ 73 million annually.
E. Summary
190. The new entity will be Almtkvlh to pay the health insurance system – enhanced development project costs of health systems – in a position to face the issues of accountability and transparency very important connection with the financing of health services and provide them in Egypt. But the project will contribute specifically to build the capacity of management and technical capacity Alehioatin in this side with the continuation of reduced administrative costs.
191. The following table summarizes the combined effects of these benefits on the total expenditure on health care in the year.
A summary of the effects of the project
The problem effectiveness of the program estimate the total impact
Manipulation and fraud 10% 25% 2.5%
Overstate the cost of services to maximize income 10% 20% 2%
Bad practices 20% 10% 2%
Administrative efficiency 10% 10% 1%

GDP at the national level of 7.5%
US $ 370 million a year
Total project (in the three pilot provinces) of US $ 111 million a year
Note: World Bank staff estimates based on international and national evidence.
192. based on the total annual revenue of US $ 370 million a year above the national coverage and health care spending estimates. It may also have been an analysis of the total annual revenues are also the three pilot provinces which will run Health Insurance Systems Development Project. Based on current data on the level of health care expenditures in the three provinces where the project is implemented as a share of total spending on health care, and in the light of the evidence shows that per capita health care spending in this higher than the national average provinces, any conservative estimate will explain that

Provide government funding to hold the verification and validation

• Provide government funding to hold the verification and validation, and will recover the amount of the loan as soon as it enters into force, in order to facilitate the choice of checking the company and authentication in a timely manner to contribute to the final selection of the package the main systems and the subsequent development of the package necessary equipment for the project pilot provinces.
• expected when choosing a verification and validation that the company is working closely with procurement staff unity of implementation of the project under the supervision of the Chief of the General Authority for Health Insurance Administration.
160. In addition to the already mentioned above more immediate measures to mitigate the risk of procurement, with respect to more sustainable capacity building; Panel recommends encouraging the procurement staff of the General Authority for Health Insurance workers main center in Cairo to participate in external training and the training of purchases on-the-job offered to them Technical support Office, in connection with the procurement manual guidance and accountability of the World Bank in order to comply with aspects related to procurement contained the loan agreement.
161. The overall risk of the project in connection with the procurement big risks, and that after the implementation of risk mitigation measures.

169. economic and financial benefits for investment arise in the development of health insurance systems through a number of channels project. Which include the efficiency and effectiveness of the remedial management point of payment such as monitoring the levels of use of services and anti-manipulation and fraud, administrative efficiency and effectiveness of medical practices on the part of health care providers. They will show benefits over time, especially during the period of implementation of the pilot project in the governorates, and the period after the project at the national level, which of course depends on the mainstreaming of the project across the country. It follows that the expectations of the benefits is subject to a number of assumptions regarding baselines, effects, and timing. But it is possible to estimate the benefits of conducting various types of analyzes, and eat later, including specifically the duration of the project and experimental provinces breakeven caller analysis, and analysis of the net benefits of the pilot provinces on the basis of a conservative estimate of the expected effects.
170. can enter claims-efficient environment based largely on paperwork that enormous effects occur in a wide variety of areas, management systems, and not only with regard to the administrative aspects of the point of payment, such as: reduce the cost of claims processing, improve claims filed accuracy; so as not to be forced by their sponsors to be resubmitted as often happens, and reduce the cost of paper claims processing, and can also be monitoring the levels of use of treatment services on practicing medicine the same affect. Examples include: unnecessary duplication of tests laboratory, low internal bed occupancy at the hospital or the failure to use equipment to some sites, poor provision of care services Coordination rates resulting in patient hospital entry without the need for, and the waste of medicines and pharmaceuticals because of poor management, and medical errors, such as interactions adverse drug, and unjustified disparities in medical care, poor follow-up of chronic diseases, resulting in poor health outcomes and higher final cost.
171. It may be difficult to estimate the financial benefits that come from dealing with these issues, let alone access to a number that represents the basis of the current line of the body. Therefore, the following calculations are based on a subset of the benefits in the areas of: (a) anti-manipulation and fraud, (b) monitor the levels of use of services, (c) clinical practices, (d) administrative efficiency.
172. Based on the types of analysis described above, we find that the potential opportunity to increase the efficiency and effectiveness of investments in the project is that even under a relatively modest set of assumptions regarding the benefits listed above, the project is able to recover its costs through a geographical and limited space of the three pilot provinces . Benefits that are likely to bear fruit by the investment in the project to provide a potential equivalent to about $ 111 million per year and may lead (pilot governorates), or 7.5 per cent of total current expenditure on health care.
173. Moreover, to reach the break-even point of the project recovers any initial investments amounting to US $ 75 million costs, it should lead to the provision equivalent to 2.7 per cent only.
Second. Elements of the project and estimate revenue
174. spends Egypt to health services is about $ 85 per person per year, or about 6 per cent of GDP, which is equivalent to as much income and other medium-sized countries, but estimates indicate that the rate of increase will be faster than the economic growth rate of about 10 percent. Indicate the fact that spending on health care has a growing share of total spending – the need to strengthen control of the financing system the cost of the capacity, which may be difficult to achieve because of the fragmented nature of the health system now, because it can not any single entity to implement the necessary mechanisms for management and administration . For example, the General Authority for health insurance expenses list has seen an increase faster than its revenue increase over the past decade, leading to exposure to a permanent disability in the operation. And it refers actuarial recent analysis government requested conducted in order to strengthen the expansion of the social health insurance system process – that the Social Health Insurance Fund will face considerable pressure to increase spending, using a reasonable set of assumptions that relate to coverage, levels of use, and the benefits of this analysis. It will be the main driver for this is the assumed usage levels of health services by beneficiaries subscribers.
175. The Health Insurance Systems Development Project will be able – through his investment in a job point of paying an effective and uniform – to contribute to the response to this challenge by developing a business model proved its usefulness backed technology-based management system and would allow the buyer tools and health information services required.
176. increasing the national and international levels to provide the evidence and the evidence of the lack of efficiency of health care services, and the manipulation and fraud and improper use of resources. At a time when the only evidence of a small amount from Egypt are not available, and it basically as a result of the problem of lack of information and management designed this project to solve systems, there are strong grounds to believe that the interventions of the project will contribute to the reduction of total health care expenditures by an estimated 6 to 7 per cent, or the equivalent of about US $ 365 million to US $ 420 million a year, once the preparation and implementation of activities in all parts of the country. These are just a conservative estimate based on reasonable assumptions, it shows high overall economic rate of returns.