PHSSR Saudi Arabia 2025

there are concerns that, if poorly designed or implemented, they may disincentivise providers from treating high-risk patients or patients with complex medical needs. Overall, there is increasing interest in value-based payment models in Saudi Arabia, and ongoing efforts to implement these models in primary, secondary and tertiary care settings. Challenges and solutions The sustainability of health system financing in Saudi Arabia faces several challenges: •The cost of healthcare is increasing at a faster rate than the increase in national income. •The current dual service provision and limited coordination between providers have led to excessive costs stemming from the duplication of services for the same case. •There is further potential for the private sector to play an expanded role in the provision of public healthcare services. Accordingly, to increase the sustainability of health financing, the government’s new Model of Care (MOC) recommends: •Establishing national health insurance. •Separating purchaser from providers in order to enhance provider autonomy, competition and accountability, while encouraging the integration of providers. •Focusing on outcomes rather than inputs. •Using PPPs to increase private sector health service delivery. Under the new MOC, and according to international best practices, the CHI is working with different entities to provide affordable, quality and comprehensive health service coverage for all residents. The Centre aims to provide a new financing mechanism for the purchase of health services from service providers by adopting a spending methodology that will ensure the continuity of current services while providing strong incentives for future development. The procurement strategy will be determined based on the health sector’s transformation strategy. The new MOC will link providers and regulators under NTP 2020 and Vision 2030 . Health system integration, empowerment of the population and increased patient knowledge are all required to meet the above-mentioned goals. The government aims to transform all existing MoH providers into Accountable Care Organisations and improve private health service provision. Along with supporting the establishment of regulations and the improvement of functions and institutions, the government aims to embed strong, delegated and devolved leadership and governance throughout the health system. Health leaders are also focused on building workforce capacity and capability, and developing e-health. Transformation of health system financing is occurring in three phases. In the first phase (2018– 2020), the government aimed to improve the capabilities of the health system, with a primary focus on the clinical system, capacity building and developing preliminary institutional infrastructure. In the second phase (2021–2025), it aims to promote the secure and robust corporatisation of key public entities. In the third phase (2025–2030), the focus will be on strengthening the value and choice of insurance schemes. This will include extending the national health insurance scheme to all citizens and residents in the country, with contributions made via employer and employee contributions, reducing the burden on general government revenues. The new health service payment model will utilise a variety of value-based payment approaches with the aim of providing safe, effective and accessible care, ensuring e fficient delivery of health services, reducing waste, making payments based on the quality of service, reducing incentives for physicians to order costly, but not highly effective, diagnostic procedures, and increasing accountability. 37 Sustainability and Resilience in the Saudi Arabian Health System The Partnership for Health System Sustainability and Resilience