Financial viability of a community-based health insurance scheme in two districts of northeast Ethiopia: a mixed methods study.
Mohammed HussienMuluken AzageNegalign Berhanu BayouPublished in: BMC health services research (2022)
The health insurance scheme in both districts spent more than it received for claims settlement in almost all the period under the study, and experienced heavy losses in these periods, implying that it is not financially viable for the period in question. The scheme is also unable to fulfill its purpose of protecting members against out-of-pocket expenses at the point of health care. Interventions should target on the highlighted challenges to restore financial balance and enhance the scheme's viability.