Managing Health Care Costing and Financing

Workshop: February 28 – March 2, 2018ILjubljana, SloveniaIApplication deadline: February 7, 2018IBudget Preparation and Execution

The workshop will examine possible approaches to the improvement of health care systems financing and reduction of sector specific fiscal risks through better coordination of allocated financial resources. It will discuss the specifics of health care sector financing, prospects for improvement of spending efficiency; coordination of funds from different national levels and utilization of external funds to ensure the desired policy outcomes. Fiscal programming challenges of the sector and possible solutions will also be addressed throughout examining good practices in the region and beyond. Moreover, we will explore the importance of linking program budgets of different national levels to enable adequate budget and policy performance.

How will you benefit?

This workshop aims to help public officials better understand key factors undermining the efficiency of health care spending, as well as shortcomings in procedures and institutional organization, in order to explain what improvements can be made to ensure better management of health care policies.

Upon completion, participants will be able to:

  • Understand the role, objectives and elements of Economic Reform Programmes and position of health care policies within this document
  • Assess how to streamline the process of spending review evaluation of health care sector and use these findings in making better budget allocations
  • Describe factors that could cause inefficiencies in health spending, and what could be done to address them
  • Appraise the benefits of utilization of performance information when making budgetary allocation decisions
  • Identify specific shortcomings in procedures and institutional arrangements that constrain coordination of health care policies. 

What will you learn?

Health care reforms will be a key fiscal challenge in coming years especially at a time when countries need to undertake large fiscal adjustments to reduce public debts in the wake of the financial crisis. Since health care spending pressures have and will continue to intensify as combination of technological advances and demographic factors, containing the growth of this spending will be an important pillar of fiscal consolidation strategies.

These developments have also been recognized by many South East European (SEE) countries by highlighting the health care reforms within their Economic Reform Programmes (ERPs) as some of the priority policies for ensuring fiscal stability and market competitiveness. Having this in mind, the workshop will outline the role, objectives and elements of ERPs while explaining the implications of health care reforms to achievement of countries’ overall fiscal objectives.  

There is not a unique attitude to providing and financing health care, because the differences in the level of public health spending across countries reflect their preferences and constraints. Therefore, there is no “optimal” level of public health spending that can provide a benchmark for comparing countries. Yet there is a need to ensure that whatever “model” for health care is adopted, public health care services are provided in an efficient way.

This workshop will provide thorough overview of the most common factors causing large inefficiencies in health spending, with the aim of unveiling how reduction of both allocative and productive inefficiencies could enable achievement of the same level of health outcomes with a lower level of spending. These findings will serve to Ministries of Finance as important input for undertaking health care spending review evaluations and preparing recommendations that combine containing costs and improving spending efficiency.

During this workshop emphasis will be put into understanding possible arrangements for adequate monitoring and evaluation of health care policy outcomes, as well as into how this performance information could be used in budgetary allocation decision making process. This is of particular importance in context of making progress towards introduction of performance based budgeting practices in SEE countries.

Furthermore, this event will provide explanation on how program budgets in health care sector could be established to foremost reflect the policy priorities. Throughout group exercises and country cases, we will give overview of how to connect program budgets of several institutions at different national levels, and to include policy objectives and key performance indicators. Programmatic budget structure should enable governments to better monitor policy outcomes of budget expenditures, ministries of finance to better coordinate and allocate financial resources, and public to ensure accountability.  

Finally, due to complexity of stakeholders involved (ministries of health, ministries of finance, health insurance funds, institutions on both national and subnational level etc.) in management of health care sector, this event will also discuss how coordination and cooperation in exchange of financial and nonfinancial data could be incentivised.  

The event will be held in English, and highly participatory. Participants will be encouraged to share their experiences and country practices.

Who should attend?

Invited are public officials in SEE who are working at: 

  • ministries of finance budget department as analysts of health care budgets;
  • ministries of health finance and policy departments participating in development and programming of health care policies, as well as on the preparation of annual budgets;
  • health care funds working on programming and budgeting of health care policies;
  • other public institutions (such as parliamentary committees, and those on subnational level) with mandate in the field of health care;
  • preparation of the inputs for ERPs in particular on the field of health care;
  • coordination, monitoring and evaluation of development and implementation of ERPs. 

No fee will be charged, and meals and refreshments provided during the event. Flights, transfers, and accommodation will be funded for up to three officials per EU 2014-2020 Instrument for Pre-Accession (IPA II) beneficiary country, as well as for one official per country from Armenia, Bulgaria, Croatia, Georgia, Moldova, Romania, and Ukraine. Applications of additional self-funded candidates from the CEF Constituency (and beyond) will be considered, as far as space permits.

Applications need to be submitted no later than February 5 via the online application form. Candidates will need to be approved by the CEF; confirmations will be sent to selected candidates by February 8.


  • Mojmir Mrak- Professor at University of Ljubljana and CEF Senior Program Adviser 
  • Mitja Čok- Professor at University of Ljubljana
  • Dorjan Marušič- International Health Care Expert and Former Minister of Health of Slovenia
  • Volkan Çetinkaya- Senior Economist, World Bank
  • Sanja Madžarević Šujster- Senior Country Economist, World Bank
  • Eva Zver- Institute of Macroeconomic Analysis and Development of Slovenia
  • Goran Drakulić- USAID's Fiscal Sector Reform Activity in Bosnia and Herzegovina


This learning initiative is supported by:

Slovenia's Development Cooperation Ministry of Finance Slovenia Safe & WB & EC
Ministry of Finance, the Netherlands