an example could be to progressively move to a mixed payment system that provides some capitation payments for patients that register with a medical practice as their chosen first point of call for health care services and feeforservice for important services like measuring blood glucose levels and lowering it for patients with diabetes the national health insurance corporation s nhic activities are focused on reimbursement and claims process and it has little scope to use the financing of health care services to drive policy changes this is instead located in another agency the health insurance review and assessment service hira whose mandate as the assurer of insurance claims limits it to paying small amounts of funds to providers the consequence of this functional separation between hira and the nhic is that no one organisation has the inhouse capacity or incentive to proactively design and implement a payment arrangement that embeds quality into purchasing