Themes
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Sub themes
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Final Codes
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Third party insurer requirements
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Financing insurance
package
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Increasing the health share from GDP
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Providing sustainable financial resources
|
Management of resources
|
Financing the healthcare insurance
|
Adaptation of measurements for reimbursement
|
Allocation of 10% of car insurance premiums for accident injuries
|
Organizational structure
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Integrating all medical funds to the Medical Services Insurance
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Establishing a High Council of Health Insurance
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Defining the country’s medical treatment system
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Making comprehensive healthcare system based on referral system
|
Tariffing the service
package
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Using actual prices and approved per capita rate for health care
|
Setting yearly tariff of services by High Council of Health Insurance
|
Developing healthcare services and tariffs based on evidences
|
Integration of policies and precedents
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Organizing integrated health insurance services based on IT and EHR
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Establishment of Iranian insurance database and elimination of overlap
|
Providing principles for contracting, behaving and monitoring insurers
|
The same instructions to examine medical claims
|
Entering new services to approve practical guidelines by MOH
|
Purchasing the benefit
packages
|
Strategic purchasing of health services from all sectors by HIO
|
Purchasing comprehensive basic and supplementary health services
|
Requiring evaluation of health technologies for health interventions
|
Performance of quality-based payment
|
Development of clinical guidelines
|
Definition framework contracts for basic health services
|
Contracting providers complying with Article17universal insurance law
|
Health care provider requirements
|
Determining
the necessities
|
Determination of comprehensive healthcare services package by MOH
|
Defining uniform basic health insurance services for the population
|
Determining of the covered basic health insurance package in three levels
|
Updating uniform approach of the list of basic insurance commitments
|
Provision of
services
|
Reinforcement of competitive market to provide medical insurance
|
Defining providing mechanism to the insured health sector evolution plan
|
Providing insurance services based on rules/regulations of High Council
|
Avoiding contract with providers aren`t interested in UHC cooperation
|
supplying the entire requirements covered by the basic insurance package
|
Rules relating to
implementation
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Creating the necessary measures for establishment of health insurance
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Notifying mechanisms for universal and compulsory health insurance
|
Cooperating between all basic insurance organizations Ministry of Health
|
Covered services
|
Full coverage of basic health needs for members of the Community
|
Reviewing the basic insurance package with health orient approach
|
Paying attention to health promotion and prevention activities
|
Allocating appropriate facilities for women
|
Insurance coverage for infertility treatment
|
Citizen/population requirements
|
Expanded coverage of population
|
Basic health insurance is universal and mandatory
|
Implementing the plan of mandatory insurance of wage earners
|
Providing free basic health insurance to all Iranian uninsured
|
Coverage of all foreigners residing in the country
|
Coverage of headed households
|
Coverage of residents of villages/cities with less than 20000 people
|
Free urban inpatient scheme to underserved poor populations
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Targeted advocacy to empower supported individuals and institutions
|
establishment of basic social security and health insurance
|
Insurance premium
|
Premium per capita healthcare coverage for insured people
|
paying the share of employees premiums by executive organizations
|
Using world experience as insurance calculations framework
|
Defining basic medical insurance of villagers and nomads
|