| Background: In Iran, during the years, the budgeting model used for healthcare funding is
affected by factors such as global oil prices and fluctuation in the exchange rates. So,
developing or continuing to implement a plan in the health system depends on the current
and future global and local economic trends.
Objective: To analyze the future of the recent significant reform called Health
Transformation Plan (HTP), started on June 15, 2014, in the light of potential financial
barriers and challenges.
Methods: Face-to-face interviews were conducted with health policymakers at different
levels of the health system, health researchers, health insurance officers, and faculty members. Also, published and unpublished documents about HTP in the country and worldwide
were reviewed. Data analysis was done using a qualitative inductive content analysis
approach and assisted by qualitative data management software.
Results: Instability of financial resources and allocation of gross domestic product (GDP) to
the HTP in the traditional way is a challenge in continuing this policy reform. Also, the
bureaucratic procedures in allocation and distribution of funds, the discrepancy between
health insurance funds and affiliated units of Ministry of Health and Medical Education
(MoHME) especially Medical Sciences Universities (MSU), the lack of purchaser–provider
split, inappropriate payments and compensation mechanisms, and dependence of MSU on
especial revenues are the main challenges that threaten the future of HTP in Iran.
Conclusion: Given the current situation, where the country’s funding resources are often
unpredictable, it seems that such funding challenges will lead to poor HTP results. Therefore,
the continuance of such a high cost-based plan requires the strategies and policies to ensure
raising additional funds through various types of innovative financing to overcome
challenges. |