2 min read
How much does a costing study cost? What drives the price
The cost of a health costing study depends on a handful of choices. Here is what drives the price, and how to scope a study that fits your budget.
Tags: costing · methods
Flagship practice area
Health financing and insurance
Insurance design, actuarial analysis, benefit-package costing and strategic purchasing for governments and insurers moving towards universal health coverage with less external funding.
The problem
Across sub-Saharan Africa, national and community-based health insurance schemes are being created, merged or redesigned, while external funding for health is shrinking. Each reform raises the same hard questions: what the benefit package will cost, what premiums and tariffs are affordable and sustainable, how providers should be paid, and who is left unprotected. These questions are usually answered separately by actuaries, health economists and policy advisers. We answer them together, because the benefit package, the premium and the payment system only work if they are designed as one.
What we deliver
Insurance design and evaluation
Scheme design options, eligibility and subsidy rules, and evaluation of existing community-based and social health insurance schemes.
Actuarial analysis and premium setting
Projections of enrolment, utilisation and claims costs; premium and contribution scenarios; long-term financial sustainability.
Benefit-package costing
Costing of essential and insured benefit packages, including the cost of adding or removing services.
Strategic purchasing and provider payment
Design and review of capitation, case-based and fee-for-service payment, tariff setting and contracting arrangements.
Financing transitions and investment cases
Fiscal space analysis, domestic resource mobilisation options, transition planning away from donor funding and investment cases.
Financial protection analysis
Measurement of catastrophic and impoverishing health spending from household surveys, and analysis of who benefits from public spending.
Methods
- Actuarial projection models
- Benefit-package and tariff costing
- Fiscal space analysis
- Catastrophic and impoverishing expenditure analysis
- Benefit incidence analysis
- Willingness-to-pay studies
- Scenario and sensitivity analysis in R
How we work
- 01
Frame the policy decision
Agree the questions the scheme or ministry must answer, the time horizon and the constraints set by law and budget.
- 02
Assemble local data
Combine enrolment and claims data, facility costs, household surveys and budget data, documenting every source and assumption.
- 03
Model the options
Build a transparent, reproducible model that links benefits, premiums, tariffs and fiscal cost, and test alternative designs.
- 04
Advise and hand over
Present trade-offs clearly to technical and political audiences and hand over the model, with training for your team.
Every engagement follows our reproducible pipeline with three expert sign-off gates.
Typical deliverables
- Actuarial or financing model in R or Excel, with documentation and a parameter table
- Costed benefit package and tariff schedule
- Premium and contribution scenarios with sustainability projections
- Policy report and decision-maker briefing
- Training for the scheme's or ministry's technical team
Health financing & insurance: guides, templates and tools
Start here: our free, sourced resources on health financing & insurance — methods guides, blank Excel templates and calculators.
Guides
- Provider Payment Methods Compared: Fee-for-Service, Capitation, Case-Based and Global Budgets
- Measuring Financial Protection: Catastrophic and Impoverishing Health Expenditure Explained
- Fiscal Space for Health: A Short Primer
- Donor Transition Readiness Checklist
- Benefit Package Costing Checklist for Insurers and Ministries
Templates
Calculators
Frequently asked questions
What data do you need for an actuarial or benefit-costing study?
Typically enrolment and population data, service use or claims data, facility costs or tariffs, and budget information. Where data are incomplete, we state the assumptions used and test them in sensitivity analysis.
How long does an actuarial or benefit-costing study take?
Actuarial and benefit-costing studies typically take 6–12 weeks. Financing strategies and purchasing reforms are usually supported over 3–6 months.
Do you work with community-based health insurance schemes as well as national insurers?
Yes. We work with national, social and community-based health insurance schemes, and with the ministries and development partners that support them.
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