Health financing reform in the primary health care in Montenegro

Abstract

Abstract Background Primary health care financing reform should be undertaken with aim to support universal health coverage, make the health care accessible and to provide a financial risk sharing in a way that prevents suffering of financial hardship. Objectives To describe challenges, development and introduction of primary health care financing reform in Montenegro. The specific objective was to assess the effectiveness of the implementation of the capitation formula. Methods This retrospective study has been undertaken to describe implementation of a capitation formula in Montenegro. Results Eight years after the implementation (2017 data) indicate that some monitoring indicators reflect output increase in the primary health care, such as number of prevention services provided to the patients (adult population of age 18 years and more). However, other indicators. e.g., number of referrals to other levels of healthcare is rising, indicating that primary care might not be meeting the adequate level of health care needs of the population. Conclusions Montenegrin experience shows that financing reform in short term resulted in establishment of a system based on output models of health care financing and increased capacities for performing main financing functions. Key messages Introduction of a capitation formula represented a fundamental shift in the way primary health care was financed in Montenegro. Further research needs to be done on how primary care responds to the needs of the population.