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Synthesis of documented international pricing experiences for CANAM - P4H Network

Synthesis of documented international pricing experiences for CANAM

The Caisse Nationale d’Assurance Maladie (CANAM) remunerates its service providers on a fee-for-service basis, according to an established fee schedule.
Users pay a co-payment (ticket modérateur) of 20% for hospitalization and 30% for outpatient care and medication.

Lessons learned from international literature cover the following topics:

  • The relationship between tariffs and costs,
  • How to calculate costs for pricing,
  • How to negotiate pricing,
  • Gathering cost information for pricing purposes,
  • Cost-adjusted rates,
  • How to take into account the objective of financial viability when defining the pricing scale, and
  • Preparing for tariff reforms.
Reference
Makinen, M. and Sissoko, O. 2022, Synthesis of documented international experience to inform revisions of CANAM's pricing system in Mali, 20 Apr 2022, Licence: Washington, DC: Palladium, Health Policy Plus.