Israeli Arab Independent Health Clinics: Personal Incentive Systems and Motivational Rewards

The Israeli healthcare system is a universal system, based on the National Health Insurance Law 1995 (NHIL), which mandates all residents in the country to join one of four official health insurance organizations, known as ‘Kupat Holim’ (HMOs). This resulted in an increase in the accessibility of health services and their distribution throughout the country. Lack of physicians, especially in the peripheries, and the competition to recruit clients forced HMOs to change and expand the concept of operating medical services. One way was to establish independent health clinics (IHCs). The current study focuses on a social and cultural phenomenon that was changed and expanded following the NHIL. The research literature lacks studies addressing IHCs in the context of the impact of the NHIL on Arab society. The research design is mixed methods with a qualitative stage followed by a quantitative stage. Specifically compiled research interviews and questionnaires were built to collect information. The main findings of the studies indicated that most physicians and managers recognized the NHIL and its contribution to the population. Addressing social and environmental rewards and deciding on moral rewards at an early stage anchored in the contract from the beginning was significant and strengthened the future of contracts between HMOs and self-employed physicians. Findings and conclusions of the study indicated a need to continue operating IHCs on condition they kept initial promises and provided feedback to physicians from time to time while improving terms of engagement, visits, and problem solving when needed in a timely manner.