Cost Revenue Analysis Tool Plus
The purpose of the Cost Revenue Analysis Tool Plus (CORE Plus) is to help managers and planners estimate the costs of individual services and packages of services in primary health care facilities as well as total costs for the facilities. The cost estimates are based on norms and can be used to determine the funding needs for services and can be compared with actual costs to measure efficiency.
CORE Plus is a spreadsheet-based tool developed by MSH with USAID and other funding to help determine projected and actual costs of integrated primary health care services broken down by individual interventions. It is a “bottom-up” costing tool that allows the user to estimate a standard cost for each intervention, broken down by drugs, tests, medical supplies and staff. The standard costs are multiplied by the number of each type of interventions to build the total direct costs for a facility to which are allocated indirect costs. The tool also allows users to estimate service utilization based on a catchment population and to compare it with actual service utilization. Costs can be easily compared for different numbers of patients and different service delivery models. A strength of the tool is to be able to predict the cost of different numbers of particular interventions, such as child survival, within the context of an integrated Primary Health Care system, and the impact of changes in those interventions on the cost of the system as a whole. The tool has been used in many countries, including South Africa, where it was used to estimate the total cost of primary health care package for the Ministry of Health.
The original CORE tool was developed in the mid 1990’s in Zimbabwe and Guatemala by Management Sciences for Health. CORE Plus was adapted from CORE in the late 1990’s in South Africa (where it was called the PHC Costing Tool).
Planners and service and finance managers
It has been applied in several countries including South Africa for national and provincial government level resource allocation; Rwanda and Haiti for government and NGO performance-based contracting; and Guatemala for assessing NGO performance and setting fees.
It can estimate the cost of individual services within integrated service facilities as well as the total cost of the facilities, and can model the financial impact of changing numbers of services, resources, and fee levels. Once the initial information is entered into the tool, it is very easy to model different scenarios, several of which are built-in. The tool can also be easily adapted.
This tool only calculates the costs of services provided through primary health care facilities.
Recommendations for Users
Managers can use this tool to see staffing and other resources needs and costs for different numbers of services, and can be use it to assess efficiency and set fee levels. The tool can be used by government or private health care providers at national, district, network or individual facility level.
Reports and Publications
Collins, D., and D. Donaldson. "Modelling the Cost of Primary Health Care Services in the Eastern Cape." The EQUITY Project. Boston: Management Sciences for Health, Mar. 2000.
Collins, D., and E. Lewis. "A Cost Analysis of Primary Health Care Services in Benoni." The EQUITY Project. Boston: Management Sciences for Health, May 2003.
Fritsche, G., T. McMennamin. "Cost and Revenue Analysis in Six Rwandan Health Centers: 2005 costs and revenues." Rwanda HIV Performance-Based Financing Project. Boston: Management Sciences for Health, Dec 2007.
The user’s manual is available in English and French
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