Although Azerbaijan’s public health spending significantly increased over the last 15 years due to the country’s high oil revenues, it’s still below spending in comparable countries and insufficient for the population’s needs. As a result, out-of-pocket health spending is very high. In 2017, the Government of Azerbaijan launched a mandatory health insurance pilot to improve financing of health care and provide people with the health care services they need—including primary health care services, outpatient services, inpatient care, emergency care, diagnostics, laboratory, and surgeries. The pilot’s success led the President of Azerbaijan to issue a decree in December 2018 to expand the mandatory health insurance nationwide. The decree emphasizes Azerbaijan’s commitment to provide world-class health care to its population and the importance of introducing a mandatory health insurance system to improve the existing financing mechanisms and improve the quality of medical services. The question is now how to convince people to enroll in the national health insurance scheme once it’s rolled out in 2020. The government will soon start sending informational materials to people about the new system and enrollment -- this evaluation will test the impact of different informational “nudges” on people’s willingness to sign up.
| Study title: | Providing Information to Increase Health Insurance Enrolment in Azerbaijan |
| Research question: | How can a government encourage payment of health insurance premiums of workers in the non-formal sector in a context of mandatory health insurance? |
| Policy problem: | Patients face high out-of-pocket payments which serve to limit healthcare utilization, but free healthcare is not financially sustainable. |
| Evaluation design: | Treatment 1 Households that receive a letter presenting the general benefits of health insurance, such as no catastrophic expenditure in case of emergencies. The letter also provides general information on the features of mandatory health insurance and how much premium different population groups have to pay. Treatment 2 Households that receive personalized information on the likelihood of utilizing heathcare based on individuals of same sex and age group from a previous pilot. The letter also provides general information on the features of mandatory health insurance and how much premium different population groups have to pay. Treatment 3 Households that receive personalized information on estimated saved out-of-pocket health expenditures from participating in health insurance based on individuals of same sex and age group from a previous pilot. The letter also provides general information on the features of mandatory health insurance and how much premium different population groups have to pay. Control Households that receive a letter with general information on the features of mandatory health insurance and how much premium different population groups have to pay. |
| Data sources: | Administrative data from the State Agency for Mandatory Health Insurance. |
| Researchers: | Volkan Cetinkaya, Markus Frölich, Alexandra Avdeenko, Susan Steiner, Iryna Postolovska, Elvira Anadolu |