Unavoidably, developing country will face geographical
monopoly, which hampers competitive contract model. Other
mechanisms such as hospital accreditation, quality improvement
and quality incentives are comprehensive intervention to
gradually overcome unsatisfactory quality of care.
Provider payment is the most critical factor contributing
to financial risk protection and technical efficiency. A few lowand
middle-income countries where closed-end payment was
not widely applied, fee for services result in cost escalation such
as in China (Hu et al. 2008; Yip et al. 2010) and high level of
out-of-pocket payment from balance billing by members of
PhilHealth in the Philippines. Most countries in the region are
moving towards capitation and DRG, such as Vietnam,
Philippines and China.