History Health Cooperatives in Costa Rica is tied to the experiment that the capitation payment CCSS conducted in Barva de Heredia, the incredible thing is that since 1988, based on this assay, we created 3 successful cooperatives in other regions and only in 1998 a company was consolidated Health Cooperative in the region following the failure of this pilot project and the Cooperative Medicoop. Background.
the late '80s the Social Security Fund (CCSS) was in the low efficiency of the outpatient or ambulatory one of the most vexing problems, hence, when in 1987 he found it need to introduce new models of care to decongest the outpatient and facilitate access to services and individual workers, strengthening the created "Medical Company" (the company pays the doctor's fee and covers CCSS medications and support services) and "Joint Medicine" (the patient pays the doctor's fees and offers CCSS medicines and tests cabinet.) At the time that previous models were introduced, and seeking to promote competition and preventive activities, we initiated a pilot Center Community Integrated Barba de Heredia with medical association Acepromazine, to use for the first time, a model of "Capitation Payment" which consisted of assigning a certain number of patients to physicians, according to free choice of the insured, calculating physician compensation based on the insured assigned; CCSS paid to the association of medical services per capita, and the association paid physicians based on the services provided to patients, in addition to The CCSS and Ministry of Health gave the local , equipment and put other staff. This pilot faced a number of management challenges for its experimental nature, not by the quality of service as management problems, as the staff of the CCSS and Ministry of Health that worked in the medical center and integrated association had contracted capitation schedules and institutional cultures that failed to be harmonized, causing dissatisfaction among the insured and local leaders asked him CCSS to reassume direct provision of services ; well established payment mechanisms were challenged by the Comptroller General of the Republic. Despite the failure of the pilot, the experience gained in Barva de Heredia was the basis for the CCSS introduced the Cooperative to provide services health and this is how in the year of 1988 promoted the creation and subsequent recruitment of Cooperative COOPESALUD RL to administer the new Pavas Clinic and served under this mode of payment and the family medicine approach to Pavas community, then in 1990, another cooperative, Coopesain RL, started in similar conditions, the provision of services in the canton of Tibás.
Seeing the success of Cooperatives COOPESALUD and Coopesaín Pavas and Tibás respectively, and after lengthy discussions, the community, medical staff and local authorities in Barva de Heredia , CCSS agreed to set up a cooperative similar to the above to make a contract similar to that carried out Pavas and Tibás. With 16 physicians who participated in the original pilot in November 1992 was the cooperative Medicoop to serve the community in the cantons of Barva and San Isidro, Heredia Province and part of the province of Alajuela. The Cooperative Medicoop not met the expectations of better service to both the community had CCSS.
born Self-Management Cooperative Integrated Health Services Coopesiba RL Barva
After several attempts at reorganization of the Integrated Center, CCSS decided to insist supporting the formation of a new cooperative, Coopesiba RL, which began in February 1998 to serve the communities of Barva, San Pablo and San Isidro, for which the CCSS gave him a building that the municipality had given Barva in 1996 and 13 Ebais. In November 2005, the city of Barva took action to collect from the CCSS the value of ¢ 2 million (U.S. $ 3,850 approx.) Monthly for the rent for the premises where work Coopesiba ; to the indifference of the CCSS , the municipality wanted to leave the Cooperative, a situation finally settled on 6 November 2006 when the CCSS reached an agreement with the Municipality of Barva to the local clinic follow operating in the City Hall building. As part of the agreement, the municipality demanded the CCSS present the plan to build the new headquarters Barva health.
Beneficiaries
currently serves a population of 60,734 inhabitants (37,378 inhabitants. In the area of \u200b\u200bBarva and San Pablo 23,356), which corresponds to 1.4% of the population national in 2006 was ¢ 20,186 for each user assigned and between 1999 and 2006 CCSS authorities issued ¢ 6.147 million in payment for health services. The CCSS evaluates and rates each year to individuals who contracted to provide health services, the most years exceeded Coopesiba 90. In December 2006, the Cooperative extended its contract for 2 years. Cooperative Management
Coopesiba In only 57 of 134 workers are partners, to join must be working for several months, take courses and make the request to the assembly, which meets once a year but not all send the request and some employees work or have worked for the CCSS , as in the case of general exgerente Coopesiba , Daisy Corrales, who was an officer of the CCSS who asked for a leave without pay, as general manager, Corrales signed the first Coopesiba management commitment, in 1998, and currently works again CCSS in Medical Management. Join together with other cooperatives in the Consortium Consalud RL, in June 2003 the hospital began operation of a private cooperative in the district of Quesada (San Carlos Canton), the first of kind in Central America (as opposed to clinics that administer cooperatives, this hospital is owned by the cooperatives formed in the consortium).
To complement and understand the role of RL Coopesiba in the health system in Costa Rica can consult the following links:
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