World Health Organization
 Collaborating Center on
 Pharmaceutical Policy

    Improving Access to and Use of Essential Medicines



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IN THE SPOTLIGHT

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Medicines and Insurance Coverage (MedIC) Initiative

Overview

Activities


Glossary of Terms Used for Pharmaceuticals and Pharmaceutical Policies in Low- and Middle-Income Countries
 

 

















Group Study Project: Accreditation and Insurance

From 26 March to 5 April 2007, BUSPH hosted a study tour by 15 members from the Kazakh Ministry of Health and Labor and 5 members from the Georgian Ministry of Health and Social Affairs. Dr. Warren Kaplan served as the BUSPH faculty representative. The study group addressed implementation of private health insurance (primary interest of the Georgians) as well as the accreditation of healthcare providers in the United States and its implementation (primary interest of the Kazakhstan group). The purpose of the project was to enable the participants to improve/modify existing practices in their own country. The course methodology was based on overview seminars plus on-site visits/lectures with both state and federal regulators. After each such visit, the group had a structured discussion (“debriefing”) to facilitate review and analysis of their experiences. Subjects reviewed with the participants included:
  • Introduction to U.S. Healthcare system
  • Licensing of Physicians and Nurses
  • Massachusetts Medical Society/MassPRO (utilization review and quality improvement of healthcare services)
  • Massachusetts Nurses Association
  • Accreditation of Primary Care Physicians
  • Accreditation of Specialist Physicians
  • Role of Insurers (Blue Cross Blue Shield) in enforcing Accreditation
  • Regulation of Massachusetts Pharmacies
  • Accreditation of Hospitals (JCAHO) domestic and international
  • Massachusetts medical reform /private insurance regulation
  • National Practitioner Databanks
  • National physician licensing exams
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Information from the Third International Conference for Improving Use of Medicines, ICIUM2011