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A consultant who has been contracted to draw up a report examining the feasibility of applying a model similar to that of the MSP (provisional health model, already operating within the INSS - Nicaraguan Institute of Social Security) to poor populations not covered by the INSS, reaches the conclusion that the model is not yet transferable as it may require urgent large-scale improvements. The case describes the MSP's progress: a 160% growth in the number of people enrolled in the program, a four-fold increase in the number of participating companies, a high level of user satisfaction, etc. Subsequently, it examines the problems in six areas: benefits, beneficiaries and registration, financing and expenses, payment systems, company selection and contracting, and provider networks.