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Health Financing – Risk Pooling and Health Insurance

Emerging Markets practice

In many developing countries, out-of-pocket spending accounts for a significant portion of total health expenditures. This regressive form of health financing can affect utilization rates, reduce equity in access to care, and push families deeper into poverty. Risk-pooling is one mechanism that can be used to help spread the costs of healthcare over a population group in an effort to reduce the catastrophic implications of out-of-pocket expenditures.

Deloitte understands the social, political and infrastructural factors that need to be considered when designing, implementing or strengthening health insurance initiatives.  For health insurance implementation to be successful, it is critical to pay close attention to the details of the design, operationalization, and execution. We help countries navigate the details and multiple dimensions of successful health insurance, including the regulatory environment, benefit package design, financing, provider payment mechanisms, enrollment procedures, and other operational requirements of an insurance scheme. Our work has helped countries expand and strengthen health insurance to improve equitable access to healthcare.

Featured projects

Risk Pooling in Afghanistan Risk pooling in Afghanistan
Deloitte is conducting a feasibility study to provide recommendations for Afghanistan to develop and implement an effective health insurance scheme.

Featured insights

Private Health Insurance in India: Promise and Reality Private health insurance in India: Promise and reality
A study of the impact of private insurance on health coverage in India.

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