Tag Archives: New Zealand

Medical underwriting and risk adjustment practices: New Zealand

Health insurance models vary from country to country. As highlighted in our first series of articles on international health markets, governments often dictate the role of private and public health insurance within any country. Milliman has produced a new series of blogs focused on the medical underwriting and risk adjustment practices of eight countries: Australia, Ghana, Ireland, New Zealand, Saudi Arabia, South Africa, Spain, and United Arab Emirates. This is the fourth article in our series.

The publicly funded health system in New Zealand is a tax-funded system that provides (largely) free healthcare at the point of use to New Zealand permanent residents and citizens, plus various other eligible groups.

The Ministry of Health allocates more than three-quarters of the $14 billion of public funds it manages through government health funding to 20 regional district health boards (DHBs). DHBs use this funding to plan, purchase, and provide health services within their areas, including primary care, hospital services, public health services, aged care services, and services provided by other nongovernment health providers including Māori and Pacific providers.

Most of the remaining public funding provided to the ministry is used to fund national services such as disability support, public health, specific screening programs, mental health, elective services, well child and primary maternity services, Maori health, and postgraduate clinical education and training.

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