Use of Data from the Witkowsky Report on the Financial Activities of the Health Plans in Decision Making in the Health System

The study examines the use of data from the “Witkowsky Report”, which is a system for monitoring the financial activities of the health plans. This system was established soon after the implementation of the National Health Insurance (NHI) Law, and one of its main goals was assisting in the law’s implementation. This study is a part of a Myers-JDC-Brookdale Institute multiyear project that examines the role of data in policymaking in the health system.

The study’s main goal was to examine the use of data from the Witkowsky Report and analyze the reasons for its extensive use. To this end, in-depth interviews were conducted with key persons in the health plans, in the Ministry of Health and in the Ministry of Finance, in research institutes, in academia and in other institutions. The interviews were conducted in late 2002 and early 2003. In addition, the research team examined the structure of the Witkowsky Report and analyzed other relevant documents.

The Report is in broad use and contributes greatly to the health system. The study findings indicate that the Report:

  • provides most of the financial information required by the system for routine follow up, control and supervision of the health plans
  • constitutes an important source for governmental decisions on funding for the health plans
  • assists the health plans in identifying weak points, increasing efficiency and economizing
  • is used by researchers in the area of health economics.

Some of the reasons for the Report’s extensive use are that it was designed to meet specific goals (relating to the NHI Law) and that it was constructed with the full cooperation of the Ministry of Health, the Ministry of Finance, and the health plans. In addition, the Report is known to be objective, professional, audited and agreed upon by all. Finally, since the Report presents current and historical data, it facilitates the monitoring of trends, administrative changes, deviations, deficiencies, improvements, etc.

Nevertheless, the study identified several limitations of the Report. Many respondents noted that the delay in receiving the Report was a drawback. Many commented that some of the expenditure and revenue items were not detailed enough. In addition, although efforts were made to unify the definitions of various items among the health plans, difficulties in comparing them remain. The Report is financial and does not include data on the quality and quantity of services provided by the health plans. In light of these limitations, suggestions for improvements are made.

The study was funded by the Connie and Bert Rabinowitz fund for Creative Breakthrough Research at the Myers-JDC-Brookdale Institute and by a grant from the Israel National Institute for Health Policy and Health Services Research.