Interoperable information systems for public health insurance

Information systems (IS) are not only key to the daily business processes of public health insurance, but also to reaching strategic policy targets, by acting as tools to support inclusive policies. Interoperability is essential to the effective administration and delivery of benefits of public health insurance schemes, including for claims management, which depends on intensive data exchanges with service providers and the broader health sector.

This brief highlights the rationale and conditions for IS interoperability in the context of public health insurance schemes. It outlines the advantages of interoperable IS and highlights the key institutional factors that need to be implemented in order to maximize the returns of interoperability.