OECD Public Governance Reviews

2219-0414 (online)
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This series includes international studies and country-specific reviews of government efforts to make the public sector more efficient, effective, innovative and responsive to citizens’ needs and expectations. Publications in this series look at topics such as open government, preventing corruption and promoting integrity in the public service, risk management, illicit trade, audit institutions, and civil service reform. Country-specific reviews assess a public administration’s ability to achieve government objectives and preparedness to address current and future challenges. In analysing how a country's public administration works, reviews focus on cross-departmental co-operation, the relationships between levels of government and with citizens and businesses, innovation and quality of public services, and the impact of information technology on the work of government and its interaction with businesses and citizens.


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Second Public Procurement Review of the Mexican Institute of Social Security (IMSS)

Second Public Procurement Review of the Mexican Institute of Social Security (IMSS)

Reshaping Strategies for Better Healthcare You do not have access to this content

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10 Jan 2018
9789264190191 (PDF) ;9789264190177(print)

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This review highlights achievements of the Mexican Institute of Social Security (Instituto Mexicano del Seguro Social, IMSS) in a number of areas – human resources, technological capacities and relations with suppliers – which were previously identified by the OECD as pivotal for the successful reform of IMSS procurement operations. This report highlights the progress made and offers recommendations to support IMSS in achieving procurement excellence and fulfilling its mandate to provide the best possible, most cost-effective healthcare services to citizens.

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  • Foreword and acknowledgements

    Overall, OECD countries have improved the quality of their healthcare, but the price tag has been high – on average amounting to 9% of gross domestic product (GDP) in 2016. While healthcare has also improved in Mexico, the country persistently ranks low for health spending, a reliable determinant of a population’s health status. Furthermore, at just above 50% of total health expenditure, the share of public financing of healthcare in Mexico is the second lowest in the OECD. In addition, Mexico is facing pressing social challenges that have substantial implications for health such as an ageing population, pollution, sedentary lifestyles and obesity. To improve value for money and reduce health inequities, the country needs to further invest in cost-effective programmes that affect the personal, environmental and social determinants of health. This includes more effective public services that use health budgets – particularly public funds – more efficiently.

  • Abbreviations and Acronyms
  • Executive summary

    In ageing societies, the quality and efficiency of healthcare services are increasingly attracting governments’ attention and citizens’ interest. While the amount of healthcare spending per capita is a baseline indicator, it is not the only determinant of how well a health system functions. Governments must also be careful to spend effectively. The Mexican Institute of Social Security (Instituto Mexicano de Seguro Social, IMSS) provides healthcare services to over 75 million inhabitants and is a key institution in Mexico’s fragmented health system. Public procurement – which represents almost onethird of government expenditure in OECD countries – provides sizeable opportunities for maximising the efficiency of healthcare spending. In Mexico, one of the lowest per-capita spenders in healthcare in the OECD, efficiency is even more vital.

  • Public procurement in the context of Mexico's health challenges

    Mexico’s health system is marked by persisting significant challenges despite recent reforms. This Chapter discusses a number of these challenges and which role public procurement can play in addressing these systemic issues. Since health expenditure per capita is one of the most crucial variables affecting health status, public procurement represents a powerful lever to maximise the value for money arising out this public spending.

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  • Expand / Collapse Hide / Show all Abstracts Human and technological capital, enablers of strategic public procurement: Progress made and existing opportunities

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    • Strengthening the capabilities of IMSS procurement staff

      Building the capability of the procurement workforce will help IMSS achieve its strategic objectives, enabling it to deliver cost-effective services to patients. This chapter explores how, by building on the work already done following the previous review, the implementation of a capability-building strategy can make a tangible difference to the effectiveness of front-line services. By learning from international best practice and implementing an attractive career path for procurement staff, IMSS will be more successful in attracting, retaining, developing and engaging its workforce.

    • Relying on comprehensive information to inform public procurement decisions at IMSS

      Fully exploiting comprehensive information from different sources will help IMSS to develop tailored strategies aiming at enhancing its procurement outcomes while delivering cost-effective services to its beneficiaries. Given the potential offered by the digitalisation of procurement processes, this chapter explores how IMSS could further leverage on existing IT tools to enhance the overall efficiency of its procurement system. Furthermore, this chapter analyses how procurement intelligence could support IMSS in delivering on its strategies. Last, this chapter discusses how IMSS could further evidence the added-value and impact of its procurement strategies.

    • Shifting IMSS contract management from supplier compliance to performance

      The satisfactory delivery of some of the most critical health services such as the provision of medicines largely depend on the capacity of suppliers to provide to the buying organisation the required products and services in a timely and effective manner. Yet, beyond the strict compliance with contractual commitments, performing suppliers could also impact more broadly the provision of health services and participate to the achievement of IMSS’ objectives. This Chapter discusses the recent efforts carried out by the Institute to ensure greater compliance of suppliers with their contractual commitments. It also suggests means to revisit the Institute’s relationship with its suppliers by developing a sound and comprehensive contract management framework.

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  • Expand / Collapse Hide / Show all Abstracts The way forward to procurement excellence

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    • Fostering stakeholder engagement in the procurement of health services at IMSS

      Openness should be a critical feature of public procurement for reducing waste, preventing corruption and restoring trust. It should not only be required in laws and regulations, but should also be part of the culture of integrity and the accountability practices of public organisations. This chapter discusses the steps taken by IMSS to ensure transparency and stakeholder participation in public procurement within the framework of Mexico’s transparency regulations. These steps include improving consultation processes when amending procurement regulations; initiatives to enhance supplier engagement so as to upgrade competition and transparency in tenders; and mechanisms to facilitate citizen participation in public procurement activities, for example as social witnesses and observers. The chapter concludes with recommendations for IMSS to strengthen still further its mechanisms for stakeholder engagement and to take transparency to a stage where citizens can benefit from systematised and consistent information.

    • Rethinking IMSS procurement strategies to maximise efficiency and sustainability

      Ensuring that IMSS procurement maximises its potential for better healthcare requires the institute to strive continuously to improve. This chapter discusses the impact of IMSS’s past procurement strategies on competition, value for money and efficiency. It also identifies possible risks which could undermine the sustainability of their benefits. It provides recommendations for mitigating those risks and to secure benefits from procurement for the institute and its beneficiaries in the long term.

    • Safeguarding integrity and managing risks in IMSS procurement

      A sound internal control system and effective risk management are critical elements for achieving IMSS's objectives and safeguarding integrity in its procurement processes. This chapter explores the strengths and opportunities for improving the strategies that drive IMSS's internal control and risk management activities. In particular, IMSS could clarify its risk management objectives for procurement, including sharpening the focus on fraud and corruption risks. The chapter also highlights how IMSS and internal control bodies could improve tools and clarify roles for managing risks in procurement processes. Priorities include making improvements to its risk assessment processes and increasing management ownership of the internal control system.

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  • Expand / Collapse Hide / Show all Abstracts Leveraging on IMSS procurement power to achieve broader policy objectives

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    • Assessing the impact of IMSS procurement on national policies

      As the largest health provider in Mexico, IMSS is an unavoidable actor of the national health system and represents a considerable source of revenue for the private sector. Therefore, this chapter explores the role of IMSS in the Mexican health system and how the entity could use its procurement to maximise the effectiveness of national health policies. In addition, considering the national impetus given to the support of small and medium-sized enterprises (SMEs) which are the backbone of the Mexican economy, this chapter assesses the measures implemented by IMSS to facilitate SMEs access to its procurement opportunities.

    • Unlocking the potential for innovation in the Mexican health system through public procurement

      This chapter focuses on the extent to which IMSS uses public procurement strategically to promote innovation and serve the institute’s beneficiaries beyond the achievement of traditional public procurement objectives. The chapter complements the general analyses previously undertaken (see Chapter 8) by discussing IMSS’s current efforts to put procurement for innovation into practice, namely to leverage its buying power as one of the largest healthcare providers in Mexico to foster innovation and other complementary objectives.

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