Moldova Health Transformation Project - DRG Costing Exercise

2016
2018
Ministry of Health
Moldova, Republic of

The overall objective of the assignment was to provide technical assistance to the National Health Insurance Company (NHIC) and the Ministry of Health in order to strengthen the function and capacity of procurement of hospital services by calculating the country hospital costs for services paid through Diagnosis-Related Groups (DRG) mechanism and recalculating the cost-weights of DRGs used to fund hospitals to reflect the actual costs for the delivery of hospital care in the Republic of Moldova.

Specific objectives were:

1. Development and adoption of a hospital services costing methodology including ”outlier” system;

2. Development and adaptation of costing tools, including specialized software;

3. Conducting the study on setting up costs. Calculation of hospital services' costs and additional costs related to rendering hospital services;

4. Calculating a new set of local cost-weights for all 695 DRGs that are used in Moldova;

5. Development of a set of recommendations to improve hospital funding policies;

6. Development of capacities for costing the services and developing cost-weights by NHIC, Ministry of Health and hospitals.

The Consultant is expected to deliver the following:

1. Evaluation of the situation (Inception report), plan of activities, methodology and tools for costing (Phase 1).

2. Progress Report regarding Study on costs (Phase 2).

3. Cost of hospital services and set of Moldovan cost-weights for DRG groups (Phase 3).

4. Recommendations for improving hospital financing policies and Report on training the staff of beneficiary institutions (Phase 4).