Stakeholder analysis of Iran's health insurance system

INTRODUCTION: This study was designed and implemented with the purpose of identify and analyze the stakeholders in Iran's Health Insurance System (HInS). MATERIALS AND METHODS: This study was a mixed method study. The study setting was in the field and consists of all organizations in the HInS. The study steps designed according to the Kammi Schmeer stakeholder analysis model. The information was collected through semi-structured and structured interviews with 16 stakeholder representatives. The data collection tool was checklist and matrixes that determined the characteristics of the stakeholders. Analysis of data was done by Maxqda(10) and Mactor software. RESULTS: A total of 34 stakeholders were identified that were involved in nine main activities of HInS. Major stakeholders have governmental nature. The Government, the Planning and Budget Organization, the Ministry of Health, the Welfare Ministry, the Higher Health Insurance Council, and the Medical Council were stakeholders who have high financial, decision-making, and political power simultaneously. The Parliament and the Health Commission, the Government, the Planning and Budget Organization, and the Ministry of Health were stakeholders that had the most influence on other stakeholders. Most of stakeholders have same position to the objectives of the HInS. The insurer organizations had opposed position with the objective of integrity of the funds. CONCLUSIONS: Stakeholders of Iran's HInS are multiple and involved in various activities that sometimes they are overlapping and parallel. Regarding the same position of the majority of stakeholders to the objectives, reforms are possible, provided that influential stakeholders participate in policies making.