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Background and Aim: Health insurance organizations play an important role in increasing people’s access to health services and protecting them financially against catastrophic health costs. Iran Health Insurance Organization (IHIO) is one of the largest public health insurance organizations in Iran, which faces many challenges. The purpose of this research is the strategic analysis of health financing performance of IHIO. Materials and Methods: This qualitative research was conducted using interpretive phenomenology method through using semi-structured interviews with 25 managers and employees of IHIO. In addition, relevant documents and archival data of IHIO were collected and analyzed. Thematic analysis method was used to analyze the data. Results: Overall, 19 strengths, 24 weaknesses, 14 opportunities, 37 threats and 43 solutions were identified for the health financing system of IHIO. Increasing the coverage of health services, correcting the information databases of the insured and electronic prescribing were the most important strengths, and inappropriate pooling of financial resources, incomplete risk pooling, high administrative costs, and inefficient control were the most important weaknesses of IHIO. The most important opportunities for IHIO include the government’s support for universal health coverage and emphasis on primary health care, legal support for consolidating health insurance funds and improving the health technology assessment system in the country. The main threats to IHIO include political and economic unstability, low health insurance premiums, decisions without scientific support and insufficient enforcement of laws. Finally, solutions such as modernizing the tax system, increasing the health literacy of the community, reducing bureaucracy, increasing transparency and accountability, and reforming the monitoring and evaluation system were identified to strengthen the performance of the financing system of IHIO. Conclusion: Iran’s health insurance organization is facing numerous structural, contexual and process challenges that have reduced its productivity. Decrease in revenues, increase in costs and decrease in efficiency have caused problems in the financing performance of this organization. Recognizing the weaknesses and challenges of financing performance and applying corrective interventions is the first step in strengthening the sustainability of health financing of IHIO.

Background and Aim: Health insurance organizations play an important role in increasing people’s access to health services and protecting them financially against catastrophic health costs. Iran Health Insurance Organization IHIO is one of the largest public health insurance organizations in Iran, which faces many challenges. The purpose of this research is the strategic analysis of health financing performance of IHIO. Materials and Methods: This qualitative research was conducted using interpretive phenomenology method through using semi-structured interviews with 25 managers and employees of IHIO. In addition, relevant documents and archival data of IHIO were collected and analyzed. Thematic analysis method was used to analyze the data. Results: Overall, 19 strengths, 24 weaknesses, 14 opportunities, 37 threats and 43 solutions were identified for the health financing system of IHIO. Increasing the coverage of health services, correcting the information databases of the insured and electronic prescribing were the most important strengths, and inappropriate pooling of financial resources, incomplete risk pooling, high administrative costs, and inefficient control were the most important weaknesses of IHIO. The most important opportunities for IHIO include the government’s support for universal health coverage and emphasis on primary health care, legal support for consolidating health insurance funds and improving the health technology assessment system in the country. The main threats to IHIO include political and economic unstability, low health insurance premiums, decisions without scientific support and insufficient enforcement of laws. Finally, solutions such as modernizing the tax system, increasing the health literacy of the community, reducing bureaucracy, increasing transparency and accountability, and reforming the monitoring and evaluation system were identified to strengthen the performance of the financing system of IHIO. Conclusion: Iran’s health insurance organization is facing numerous structural, contexual and process challenges that have reduced its productivity. Decrease in revenues, increase in costs and decrease in efficiency have caused problems in the financing performance of this organization. Recognizing the weaknesses and challenges of financing performance and applying corrective interventions is the first step in strengthening the sustainability of health financing of IHIO. [ABSTRACT FROM AUTHOR]

Objective (s): Due to rapid growth in health care expenditures in recent decades, finding new methods to control costs seems necessary. As such activity based costing (ABC) is one of the new costing methods that increasingly used by managers. This method will help managers to better control costs. This study aimed to investigate the possibility of using activity-based costing system in a specified range of imaging services (radiology and sonography) in centers under the contract of Iran Health Insurance Organization.Methods: This was a multi-phase study so different methods were used. First a review of the literature on the topic was carried out. Then related centers (public and private) were selected randomly. The study population was hospitals and radiology centers under the contract of Iran health insurance organization in Tehran, Iran.. Data was collected by system observation, review of documents and interview by system experts.Results: The centers were classified into 3 groups according to the financial documentation: For group A all 4 categories of financial data were accessible for implementation of ABC in systems. For group B the costs of unit and batch level were available and for group C only the costs of unit level can be estimated.Conclusion: The findings suggest that financial data documentation in different centers is the most important factor that affect the feasibility of using the activity-based costing techniques. To control costs in health care it seems that there is need to improve financial documentation both in public and private hospitals.