Open Enrollment

Introduction of the nationwide open enrollment (OE) system, which gives the patients a chance to choose a PHC provider at their own discretion, is one of the key elements of the primary healthcare reform in Armenia. The OE principle is to replace the existing practice of service provision through catchment areas, where PHC physicians are assigned to the patients based on permanent residence locations. OE will promote competition among the PHC providers to enroll a larger number of patients fostering a more customer-oriented approach and improved quality of care.

To achieve the goals set for this component, the Project has been working to:

    •   Assist the Ministry of Health in developing and introducing OE policies and regulations;

    •   Create and install OE information system and database, carry out facility needs assessment and procure hardware required to support the OE system;

    •   Build public awareness of the OE concept.

Regulatory Environment

On March 30, 2006, the Government issued the decree on OE, which was enforced from January 1, 2007. As part of its support to the implementation of the OE nationwide, the Project developed in collaboration with the Ministry of Health the derivative instructions and procedures on how the legislation should be applied operationally. Such documented procedures cover enrollment record and reporting forms; data entry, storage, cleaning and duplication adjustment; data retrieval conditions, confidentiality requirements.

OE System and Capacity Building

A major component of the preparatory phase is the development and deployment of the national OE system to track where patients are registered and evaluate provider performance. The system will cover more than three million population and several thousand PHC providers.

The Project team has collected and structured data on PHC facilities in Yerevan and marzes, while also finalizing system feature requirements for the software development. The automated OE system has now been developed and tested, and is ready to be installed in PHC facilities nationwide. Based on the needs assessment conducted, the Project will also procure and install hardware required to support the system, including three high capacity servers in Yerevan and 10 medium capacity ones in ten marzes, as well as nearly 200 desktop computers with peripheral equipment in facilities countrywide.

As the OE system rolls out, the facilities will require well-trained data input officers to operate the database. The Project is developing training curricula and materials and will hold OE related and computer literacy training for Government staff, regional OE coordinators, as well as PHC facility staff.

Public Education on OE

OE public awareness campaign is a crucial part of the OE implementation process, as it is important that the patients should be aware in advance of the benefits of the OE, where and how to enroll, and who is eligible. The Project's public education efforts will include OE related television and radio programs broadcasted nationwide, printing and dissemination of patient information leaflets, as well as media training and workshops. Public awareness raising activities started in mid-2006 and extend into 2007.