contrary to the situation in most oecd countries health system priorities in mexico and consequently the whole information infrastructure in place at both system and institution levels remain focused primarily on the number of people covered by some sort of health insurance and the associated cost of such coverage by contrast the performance of health care services is not monitored systematically posing challenges for shifting towards system governance based on improving health outcomes specifically a set of policies is presented to encourage a more productive organisation of insurers and providers based on the experience of other countries that have faced similar challenges to mexico such strategies involve changes to how the roles of purchaser provider and oversight are currently organised how the purchasing of goods and services and provider reimbursement occur and how the health system information infrastructure is set up