Table 7 Changes in CBI payment mechanisms based on the results of this study

Capitation payment level

The enrollment premium was 500 FCFA ($1 USD) for children under 15 and 1500 FCFA ($3 USD) for adults 15 and older.

The enrollment premium is 500 FCFA ($1 USD) for children under 15 and 1500 FCFA ($3 USD) for adults 15 and older. A 1000 FCFA subsidy for children is added for each child enrolled, resulting a capitation level of 1500 FCFA for children and 1500 FCFA for adults.

Capitation payment schedule

The capitation was paid once a year, normally in July or August.

The capitation is paid twice per year, once in April (after the first three months of the enrollment period) and once in July (after the closing of the enrollment period).

Allocation of medical supplies and equipment

No medical supplies or medical equipment were provided to the facilities that are contracted with the CBI scheme.

No change from previous mechanism.

Reimbursement of consultation and service fees

None.

100% of consultation fees of CBI enrollees are calculated at the end of the calendar year and reimbursed to health facilities during the first quarter of the following calendar year.

Capitation deficit reimbursement

If enrollees were prescribed more drugs than the capitation covers, the deficit was calculated at the end of each calendar year and reimbursed during the first quarter of the following calendar year.

No change from previous mechanism.

Results-based financing (RBF) provider payment mechanism

None.

For each individual enrolled in a primary-care facility (CSPS) catchment area, the primary-care facilities are paid 200 FCFA ($0.40 USD) per new enrollee and 100 FCFA ($0.20 USD) per re-enrollee. Payments are divided between a direct global payment to the facility health worker team (75%) and the health facility account (25%), and will be paid in April and July. The secondary-care facilities (CMA) do not receive any RBF payments.