How health benefits packages are developed and revised around the world

Abstract

Developing and reviewing the health insurance benefit package is one of the important tasks in order to efficiently perform the function of purchasing - one of the three core functions of health insurance. This paper examines how countries around the world define the benefits package of technical services, and form development methods and review criteria. The basic search terms included “gói quyền lợi”/”benefit package”, “danh mục dương tính”/”positive list”, “danh mục âm tính”’/”negative list”, “danh mục thanh toán bảo hiểm y tế”/”reimbursement list”. Sources include Pubmed, Google Scholar, World Health Organization (WHO), World Bank (WB), United Nations (UN) and Organization for Economic Cooperation and Development (OECD). Results: There has not been any study to review the status of the health benefits package worldwide. This paper shows the diversity in regulations on the definition of health benefits packages. The paper also focuses on lessons learnt from other countries on the process of developing and revising as well as the criteria for the health benefits package.