New funding for a new Brazilian primary health care

Abstract

This paper aims to present a debate on the new Brazilian Primary Health Care (PHC) funding policy. We consulted the national and international literature, and we involved munic-ipal, state, and federal PHC managers to develop the payment method. The proposed final model is based on weighted capitation, payment-for-per-formance, and incentive for strategic actions. Capitation is weighted by the socioeconomic vul-nerability, demographic aspects, and municipal adjustment, the payment-for-performance con-sists of an entire set of 21 indicators, and incen-tives for strategic actions were facilitated from the maintenance of some specific programs. The results of the simulations pointed to low registration (90 million Brazilians) for the currently estimated coverage (148,674,300 Brazilians). Moreover, they showed an immediate increase in financial resources for 4,200 Brazilian municipalities. We observed that the funding proposal brings Brazilian PHC into the 21st century, points to the strengthening of PHC attributes, and materializ-es the principles of universality and equity of the Unified Health System.