Table 1 CBI payment mechanisms, 2004-2010

Capitation payment level

The enrollment premium was 500 FCFA ($1 USD) for children under 15 years of age and 1500 FCFA ($3 USD) for adults 15 years of age and older. 10% of the total of capitation payments was reserved for the CBI management, and the remaining 90% was split between primary- (3 quarters) and secondary-care (1 quarter) facilities. The capitation payment was meant to cover all drug costs for enrollees during the calendar year.

Capitation payment schedule

The capitation was paid once a year, normally in July or August, after the annual enrollment campaign closed (end of June each year).

Allocation of medical supplies and equipment

Neither medical supplies (cotton, alcohol, Bétadine, Sparadrap, etc.) nor medical equipment (tension meter, stethoscope, thermometer, scale, height gauge) were paid for by the CBI scheme.

Reimbursement of consultation and service fees

None. The capitation paid to facilities was meant to cover only the cost of drugs prescribed to enrollees. Fees for consultations and services consumed by enrollees were not covered by the annual capitation, nor included in the calculations to determine the annual deficit reimbursement (see below), and were not paid by CBI enrollees.

Capitation deficit reimbursement

If the total cost of drugs prescribed to enrollees exceeded the capitation payment, the resulting deficit for each calendar year was reimbursed (by an external fourth party) during the first quarter of the following calendar year.

Results-based financing (RBF) provider payment mechanism

At the time of the study, there existed no results-based financing provider payment mechanism (financial or non-financial) linked to CBI coverage.