UPMB recognizes that as an organization that serves those mostly in rural and remote areas, many of the people in these target areas are often unable to pay out of pocket for the services they need, and often make difficult decisions about accessing health care that perpetuate ill-health or result in poverty. UPMB intends to seek effective alternatives in order to provide rural households a permanent solution to the problem of accessing health care. UPMB facilities are currently working on a cost sharing basis where all clients that visit these facilities contribute a very minimal token in form of user fees for the services. Research has proved that this model is not effective in promoting access and utilization of health care services.

Through Community Health Insurance (CHI), communities contribute a premium fee (subscription, usually at flat rate) towards their medical treatment to a specified medial facility. These schemes allow funds to be pooled to reduce financial barriers for those who need to use services they could not otherwise afford. These CBHIs mainly offer emergency care but not chronic care. The CBHIs have helped to create community ownership and organized structures that facilitate the implementation of primary health care by incorporating public health and behavior change initiatives through these pathways. Additionally, the public health and health promotion activities are made possible and sustained through the CBHIs premiums. This is seen as a good investment in promoting health and well-being of communities while greatly reducing the burden of disease and improving health seeking behavior.

At the national level, UPMB is actively involved in advocating for the mainstreaming of CHIs into the NHIS with partners such Health Partners, Save for Health and other Medical Bureaus.  UPMB strives to improve access to health care among the poor; and protect the poor from indebtedness and impoverishment resulting from medical expenditures. CHI schemes involve prepayment and the pooling of resources to cover the costs of health-related events.

UPMB CHI schemes generally targets low-income and quite diverse populations, ranging from people living in the same town or district, to members of a micro-finance groups. These schemes are implemented by member health facilities, and target residents from the surrounding area. CHI initiatives are based on the following characteristics: voluntary membership, non-profit objective, linked to a health care provider (often a member health facility in the area), risk pooling and relying on an ethic of mutual aid or solidarity. This solidarity and trust stir up members who are susceptible to risk to put together their resources for common use.  Therefore, UPMB supports its member health facilities to identify and leverage on the already existing social capital in the communities it serves.

Overall goal: To increase access to affordable quality health services in communities through establishing functional Community Health Insurance Schemes in at least 80% of the Member Health Facilities.

Objectives:

1. To make medical services accessible to the disadvantaged and less privileged people in the community
2. To lessen the financial burden on medical bills for all the affiliated institutions as well as the local community.
3. To ensure all patients access the prescribed drugs at the member health facilities throughout the year.
4. To increase on the clientele base and ensure its sustainability
5. To Increase on the quality of care and increase customer satisfaction

More than 42 facilities within the UPMB network have ongoing prepayment schemes in the form of Community Based Health Insurance schemes with a membership of 96,192 individuals enrolled. UMPB has a network of 302 health facilities. Majority (80%) of these are located in rural and remote areas and include 19 hospitals; 10 Health Training Institutions; 10 HC IVs; 263 lower-level health facilities.