Administrative Models in Health Insurance

At the CISS we have stressed the idea that attention should be paid to administrative issues in order to improve cost efficiency, users satisfaction and eventually affiliation to social security institutions. Our annual report 2008 analyzes these ideas in detail.
In particular for healthcare we have argued that all process should be performed using the best practices (see diagram below). Unfortunately, currently in many countries health insurance programs ignore the middle process, the processes that have to do with risk management, account maintenance and customer care and management of providers.





It is important to clarify that our opinion that all healthcare institutions should develop each and all of the process do not straightforward imply that we are suggesting a separations and possibly privatization of organizations. Nevertheless, for those countries that find the separation of organization an appropriate model, the development of functions can be a very useful previous step.