Project references


Below is a description of projects and activities undertaken by the firm the over period of the last five years.

BOSNIA AND HERZEGOVINA: Tuberculosis and HIV/AIDS project - Development of national health sub-accounts for TB and HIV/AIDS, UNDP, (2014 - current)

The System of Health Accounts is the standard international methodology that provides a comprehensive estimate of all national health expenditures. Sub-accounts assist in the monitoring of financing flows in the prevention and treatment of specific diseases. The project is developing sub-accounts for TB and HIV and involves the development of a methodology, data collection, analysis and the constructing of the accounts.

CROATIA: Development of an implementation plan for rationalization and outsourcing/spin off of non-clinical services (NCS), World Bank, (2013 – 2014)

The project addressed the problem of inefficiency in the provision of non-clinical services (NCS) in public hospitals in Croatia. The key project deliverables were the analyses of the non-clinical service staffing levels across the sector and the development of an action plan to implement appropriate reforms.

Project activities included: examination of legislative and operational issues related to NCS reform; estimating of the costs of NCS delivery across the sector and potential for savings; examination of international experience in NCS reform; preparation of templates for outsourcing contracts including specifications, and planning for the implementation of reforms.

CROATIA: Communication support for the health system reform awareness-raising campaign, World Bank, (2013)

The aim of the assignment was to assist the MOH in strengthening its communication capacity and in developing and implementing a nation-wide public relations campaign to support the health care reform process in Croatia. The main objectives of the project were: to create an increased awareness of the Croatian public about the underlying reasons behind the needs for health system reforms, and how these reforms will benefits citizens; and to build strategic partnerships with opinion-leaders and decision-makers, including the mobilization of various interest groups to support the reform process.

The project included four key activities: 
conducting public opinion surveys about public perception on the health system reform; strategic planning and the conduct of a major public campaign; organization of stakeholder forums; and the conduct of workshops.

(The project was undertaken in collaboration with Digitel komunikacije d.o.o). 

BOSNIA AND HERZEGOVINA: Public Health Reform II, European Commission, (2013)

The project supported health care reforms in BiH through harmonization of relevant public health legislation with EU directives and guidelines in order to enhance evidence based planning of public health strategies.  

Activities implemented under the project involved the following components: (a) capacity building of public health systems in BiH in order to increase their readiness to respond to threats to public health (pandemic, bio terrorism, natural disasters etc.); (b) enhancement of methods to assess the health status the population and improve the system of reporting on communicable diseases; and (c) improvement of the collection of data and analysis for the reporting of the National Health Accounts.

The consultancy developed a methodology that enables BiH to use DRG activity data for the EU Payment Per Performance survey.

(The project was undertaken for CEU Consulting GmBH).

CROATIA: DRG development – Strategic report, Croatian Health Insurance Fund, (2013)

This assignment was to develop a framework for the continued implementation of the DRG system in Croatia. The project identified priority and high value interventions that would lead to the effective utilisation of the DRG system for measuring production and supporting the improvement of efficiency of the public hospital sector.

The assignment activities included: evaluation of the main institutional issues; the review of the current payment model; DRG data analysis; review of skill needs; and the development of a strategic implementation plan. 

BOSNIA AND HERZEGOVINA: Reform of Financing Secondary Health Care, European Commission, (2011-2013)

The goal of this project was to improve the effectiveness and efficiency of hospitals in Bosnia and Herzegovina through implementing a new system of hospital payments based on performance as measured by DRGs.

Project activities included: AR-DRG coder and auditor training; AR-DRG data analysis; development of new performance based contracts; legal analysis; recommendations of pathways for hospital efficiency gains including business planning and same day procedures; and the analysis of ICT capacity of hospitals and health insurance funds including the development of a strategic ICT investment plan.

MONTENEGRO: Advisory Support in the Adoption of Hospital Payment System and Contract, World Bank, (2011-2013)

The project was a component of the hospital reform initiative in Montenegro and involved: implementing the AR-DRG patient classification system; providing AR-DRG training and data analysis; design of a hospital financing strategy so that funds are allocated to the needs of patients; design of a new payment system and hospital contract that will include performance measurement using DRGs; and development of an action plan for the further development of DRG capacity and full implementation of the DRG system.

CROATIA: Undertaking of economic studies for pharmaceuticals, (2010 – 2012)

Karol Consulting was awarded several contracts by pharmaceutical firms to undertake economic studies and writing submissions for the inclusion of these drugs on the Government’s subsidized list of drugs. The work involved HTA, research on drug effectiveness, efficacy and pricing. The submission argued the value for money case why the particular drugs should be subsidized in Croatia and in all cases the drugs for which submissions were made by the firm, were included on the list.

CROATIA: Development of Emergency Medical Services (EMS) and Investment Planning Project - Development of service-plans and physical standards, World Bank, (2010 – 2011)

The project aim was to assist the Croatian Institute for Emergency Medical Services in the development of a strategy and standards for EMS provision in both pre-hospital and hospital settings. Project deliverables included a plan and time-frame for a new EMS delivery framework in Croatia. Planning activities included the review of the current situation in Croatia, analysed international standards and made recommendations on EMS standards appropriate for Croatia. The project made recommendations on methods to rationalise the current system of EMS delivery, including the geographic re-distribution of EMS centres, the reform of the EMS operational systems and new EMS staffing arrangements. The project deliverables included: situational analysis; report on relevant international EMS best practice; and EMS reform implementation plan.

MACEDONIA: Designing and Implementing Hospital Payment Reform, World Bank, (2008 – 2009)

The project implemented an output-based hospital payment system using the Australian DRGs Classification. The aim of the new system is to provide incentives to hospitals to improve their efficiency and quality of care. Project activities include: developing standardised systems of hospital data collection: DRG coding training, collecting performance data on utilisation; service costing and quality of care; DRG data analysis and feedback to providers; development of an outputs based hospital payment model and the phasing in of performance payment incentives; developing approaches for DRG costing and the financial modeling of hospital payments based on their DRG activity; development of the Macedonian DRG grouper; institutional development of the health insurance fund and hospitals; and DRG system management training and capacity building.

BOSNIA AND HERZEGOVINA: Health Sector Enhancement Project – Capacity Building in Contracting, World Bank, (2008 – 2010)

The project was undertaken for the Andrija Stampar School of Public Health and supported the building of BiH capacity in healthcare management. Karol Consulting had responsibility for the contracting component of the training project and provided the following services: advising on the target groups that should undertake the training; undertaking a training needs analysis to identify current skills and attitudes as well as priority needs; developing a training methodology and program that included contributions from local and foreign experts; developing training content for 10 training modules including reading materials; topic summaries and presentations; delivering interactive training sessions that included theory, case studies and exercises.

MACEDONIA: Basic Benefits Package – Redefinition, World Bank, (2010)

The consultancy advised the Government of Macedonia on health reform policy issues related to the content of the basic benefits package, the schedule of co-payment and the role of voluntary health insurance in the health financing framework. The project included the following activities: producing financial estimates of the benefits package and prospective co-payment income; advising on the options for the introduction of voluntary health insurance and the content of insurance packages; and review of the health insurance law and advising on amendments.

AZERBAIJAN: Improving Delivery of Healthcare Services - Management Training Modules, World Bank, (2007 - 2008)

The consultancy developed management and finance training modules for hospital and primary care managers as part of Azerbaijan health reform initiative. The training modules covered the following topics: key features of healthcare delivery systems including system organization and evaluation; administrative practice in healthcare; healthcare financing including budgeting, costing; fiscal control and purchasing; and quality in healthcare including the concepts of operations management and quality control.

MACEDONIA: Development of a National Co-payment Policy, World Bank, (2007)

The objective of the project was to revise the existing co-payment policy in Macedonia in order to support the financial sustainability of the basic benefits package while, at the same time, protecting access to benefits by the vulnerable population groups. The project reviewed the current system of user fees and co-payments and proposed a policy on exemptions from user fees. It also: examined the financial and equity impact of the available policy scenarios; addressed matters related to compliance and informal payments; and advised on how additional revenues can be generated for the Macedonian Health Insurance Fund.

MALAYSIA: Development of the National Health Financing Mechanism, UNDP, (2006 - 2007)

This project is central to the implementation of health financing reform in Malaysia. It was comprehensive in its scope and included: analysis of health and economic data; review of the methods of health financing; analysis of the roles of the public and private sector; development of proposals for a mandatory and universal health insurance system; the design of a basic benefits package; development of a provider payment framework including DRGs; establishment of a national health financing authority, development of the operational principles for the health insurance system; a financing reform implementation plan; the design of a social marketing strategy; and the development of a framework for a health information system. The project was stopped prior to final reporting for political reasons.

TURKEY: Strengthening and Restructuring of Health Services Financial Management Project, (2005 – 2007)

The consultancy was undertaken for Medicare Australia and aimed at improving health financing effectiveness and quality of care by developing prospective payment and budgeting mechanisms based AR-DRGs. The project also developed systems for medical material management. Specific interventions included: evaluation of hospital budgeting systems; analysis of provider incentives; review of different payment models; casemix funding design including DRG development; development of hospital payment models; development of classification and coding standards; and system piloting and training. Karol Consulting provided technical assistance related to project management and activity coordination.

BOSNIA AND HERZEGOVINA: Development and Pilot-Testing of New Provider Payment Mechanisms, World Bank, (2005 – 2007)

The consultancy was undertaken for Medicare Australia. The project scope included the defining, design, pilot testing, evaluation and planning for the roll-out of a new provider payment system which included DRGs. The main aim of the project was to introduce incentives for providers to improve efficiency and health outcomes.

Contact us

Karol Consulting d.o.o.
Šestinski vrh 61
10 000 Zagreb


Our work spreads across wide range of projects.

See project references to view the list of projects.