Terms for how health systems raise and pool funds, insure populations and pay providers.
Risk pooling is the accumulation and management of prepaid health funds for a defined population so that the financial consequences of health-care need are shared across members rather than borne solely by each person when illness occurs.
A mandatory payment, typically a percentage of income, made into a social insurance scheme to fund healthcare or other benefits.
A financing approach where a payer actively negotiates prices, selects high-performing providers, and designs incentivising payment mechanisms, unlike passive purchasing.
An entity, other than the patient or provider, that finances healthcare costs on behalf of a covered individual, such as an insurer.
Universal health coverage is the goal that everyone can obtain the quality health services they need throughout life without experiencing financial hardship.
A general term for arrangements tying provider reimbursement to quality, efficiency, or outcomes, rather than volume alone under fee-for-service.
In health economics, health insurance bought at the discretion of individuals or employers rather than mandated by the state, often supplementing public cover.